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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK ®B3 OPERATING PERMIT APPLICATION-TANK INFORMATION(One form per UST) TYPE OF ACTION (Check one item only For an UST permanent closure or removal,complete only this section and Sections L IL III,IV,and IX below) 430 ® 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION 6.TEMPORARY UST CLOSURE 7.UST PERMANENT CLOSURE ON SITE 8.UST REMOVAL DATE UST PERMANENTLY CLOSED: 430& DATE EXISTING UST DISCOVERED: 430b L FACILIT _I7�ltMA"I`fl1V FACILITY ID B(Agency(Ise Only) F A _ O Q 010 O I` BUSINESS NAME(Sartre as FACILITY NAME or DBA-Doing Business As) 3 Tesoro West Coast Company, LLC#68150 BUSINESS SITE ADDRESS 103 CITY 104 13975 e.Hwy 88 Lockeford,Ca.95237 II.TAMC DESCRIPTION TANK ID# 005 432 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK IS 434 Xerxes ❑1.A STAND-ALONE TANK G ®2.ONE IN A COMPARTMENTED UNIT. C/ Complete one Page for aah c0awaynew to Use uM DATE U.T SYSTEM RJSJAI.I,ED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437 2012 MAI q 14 20000 Two III.TANK US AND CONTENTS TANK USE M la MOTOR VEHICLE FLIFLING ❑ lb MARINA FUELING ❑ Ic.AVIATION FUELING 439 ❑ 3 CHEMICAL PRODUCI STORAGE ❑ 4 HAZARDOUS WASTE(I rch ks Used Oil) ❑ 5 EMERGENCY GENERATOR FUEL(HSC 425ZSI 5(c)) ❑ 6 OTHER GENERATOR FUEL ❑ 95,UNKNOWN ❑ 99.OTHER (Specify), 4392 CONTENTS PETROLEUM ® It REGULAR UNLEADED ❑ Ic.MIDGRADE UNLEADED ❑ Ib PREMIUM UNLEADED 440 ❑ 3 DIESEL ❑ 5 JET FUEL ❑ 6 AVIATION GAS ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM S i ): 4402 NON-PETROLEUM0 7 USED OIL ❑ 10.ETHANOL ❑ 11.OTHER NON-PETROLEUMS i : 440% IVT TANK.CONSTRUCTION TYPE OF TANK E3 1,SINGLE WALL ® 2.DOUBLE WALL95.UNKNOWN 443 PRIMARY CONTAINMENT El 1.STEEL ® 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 444 ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN 1399.OTHER ): 4442 SECONDARY CONTAINMENT 1 STEEL ®3 FIBERGLASS 6.EXTERIOR MEMBRANE.LINER 0 7 JACKETED 445 ❑ NONE 1395 UNKNOWN [399 OTHER(Spw6'), 4452 OVERFILL PREVENTION 1 AUDIBLE&VISUAL ALARMS 0 2 BALL FLOAT 0 3 FILL TU13E SHUT-OFF VALVE 452 ❑ 4.TANK MEETS RE UIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT/'WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION1-SINGLE-WALLED 2.DOUBLE-WALLED [199.OTHER 460 SYSTEM TYPE ® 1 PRESSURE ❑ 2 GRAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION 23 CCR 2636(8X3 459 PRIMARY CONTAINMENT ❑ 1 STEEL ® 4 FIBERGLASS ❑ 8 FLEXIBLE. ❑ (0.RIGID PLASTIC 464 ❑ 90.NONE ❑ 95 UNKNOWN ❑ 99.OTHER( i ) 4648 SECONDARY CONTAINMENT ❑ 1 STEM, ® 4 FIBERGLASS ❑ 8 FLEXIBLE ❑ 10 RIGID PLASTIC 4"b ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99 OTHER(S i ): 464c PIPING,TURBINE CONTAINMENT SUMP TYPE ❑ 1.SINGLE WALL IM 2.DOUBLE WALL (3 90,NONE 064d VI.VENT,VAPOR;RECOVERY")AND RISER/FILL PIPE_ PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT U 1 STEEL 0 4 FIBERGLASS U 10 RIGID PLASTIC 90 NONE 99.OTHER(Specify) 464e 464e1 VENT SECONDARY CONTAINMENT El 1 STEEL 0 4 FIBERGLASS 10 RIGID PLASTIC 90 NONE 99.OTHER(Specify) 464f 464n VR PRIMARY CONTAINMENT 0 1 STEEL 0 4 FIBERGLASS 0 10 RIGID PLASTIC 0 90 NONE 94.OTHER(Specify) 464g 464SI VR SECONDARY CONTAINMENT 1 STEEL a 4 FIBERGLASS 10 RIGID PLASTIC E3 90 NONE 99 OTHER(Specify) 464h 4601 VENT PIPING TRANSITION SUMP TYPE I.SINGLE WALL 0 2 DOUBLE WALL 90.NONE 464i RISER PRIMARY CONTAINMENT 10 1 STEEL El 4.FIBERGLASS 0 10 RIGID PLASTIC U 90.NONE U 99.OTHER(Specify) 4641 464 1 RISER SECONDARY CONTAINMENT 0 i.STEEL 0 4.FIBERGLASS 0 10,RIGID PLASTIC IM 90,NONE 0 99.OTHER(Specify) 464k 464ki FILL COMPONENTS INSTALLED 0 1 SPILL BUCKET 3.STRIKER PLATE BOTTOM PROTECTOR 0 4.CONTAINMENT SUMP 451" VII.TINDER DISPENSER GCUN.TAINA , ) CONSTRUCTION TYPE ❑ 1.SINGLE WALL ® 2.DOL11"WALL.- ❑3.NO DISPENSERS ❑ 90.NONE 469' CONSTRUCTION MATERIAL 0 I.STEEL 10 4.FIBERGLASS ❑ 10.RIGID PLASTIC 0 99.OTHER(specify) 469bc VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRFNI ❑ 6 ISOLATION 448 .; .. LICANT JIcjNATURE CERTIFICATION: I certify that this UST system is compatible with the hazardous substance stored and that the information provided herein is true,accurate, and in full compliance with Iclal requirements. APPLICANT SIGNATU DATE 2-23-12 470 APPLICANT NAME(print) andy Edwar 6 4" APPLICANT TITLE:Envirminental Comphancc Administmor 472 UPCF UST-B-112 Rev.(12/2007)