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UNIFIED PROGRAM CONSOLIDATED FORM B UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION TANK INFORMATION(one form,W Us TYPE OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections 1,11,111,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: 4308 DATE EXISTING UST DISCOVERED: 4306 L F*114ITY)FNFI RMz 3� . FACILITY ID#(Agency Use 0*) F JAI'-,, '- 0 10 0 0 0 1Sjd 1 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 Tesoro West Coast Company, LLC 168150 BUSINESS SITE ADDRESS 101 1 CITY 164 13975 e.Hwy 88 Lockeford,Ca.95237 11.TANK DESCRIPTION TANK ID# 432 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK IS 434 t Xerxes ❑1.A STAND-ALONE TANK _QLD 0 2,ONE IN A COMPARTMENTED UNIT. �( coniplete one PM for each compartmm inthewrit. DATE US STEM INSTALLED 033 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437 2012 12000 Two III.TANK USE AND CONTENTS TANK USE IN la.MOTOR VEHICLE FUELING ❑ ib_MARINA FUELING ❑ le.AVIATION FUELING 439 ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4 HAZARDOUS WASTE(laciudes Used Oil) ❑ 5 EMERGENCY GENERATOR FUEL[HSC§25281 5(c)) ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER (Specify). 4392 CONTENTS PETROLEUM: ❑ la.REGULAR UNLEADED ❑ Ic MIDGRADE UNLEADED ® Ib.PREMIUM UNLEADED 440 ❑ 3 DIESEL ❑ 5 JET FUEL ❑ 6,AVIATION GAS ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM (Specify): 4408 NON-PETROLEUM.0 7 USED OIL 0 10 ETHANOL ❑ 11.OTHER NON-PETROLEUM t 4401, IV. TANK,CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL C9 2 DOUBLE WALL ❑ 95.UNKNOWN 443 PRIMARY CONTAINMENT 0 I STEEL 1@ 3.FIBERGLASS El 6 INTERNAL BLADDER 444 ❑ 7.STEEL�INTERNAL LINING ❑ 95 UNKNOWN ❑ 99.OTHER (Specify). 444a SECONDARY CONTAINMENT ❑ 1 STEEL ®3 FIBERGLASS ❑ 6 EXTERIOR MEMBRANE LINER ❑ 7 JACKETED 445 ❑ 90.NONE ❑ 95.UNKNOWN ❑99,OTHER(Specify). 4452 OVERFILL PREVENTION 1 AUDIBLE&VISUAL ALARMS 2 BALL FLOAT 3.FILL TUBE SHUT-OFF VALVE 452 ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V.. PRODUCT/WASTEPll'ING CONSTRUCTION PIPING CONSTRUCTION ❑I SINGLE-WAILED ®2 DOUBLE-WALLED ❑99 OTHER 460 SYSTEM TYPE ® 1.PRESSURE ❑ 2.GRAVITY ❑ 3,CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION 123 CCR 2636(ax3) 458 PRIMARY CONTAINMENT ❑ I STEEL 0 4 FIBERGLASS E3 S.FLEXIBLE ❑ 10 RIGID PLASTIC 464 ❑ 90 NONE ❑ 95.UNKNOWN ❑ 99.OTHER( if). 464a SECONDARY CONTAINMENT ❑ 1 STEEL ® 4 FIBERGLASS ❑ 8 FLEXIBLE ❑ 10 RIGID PLASTIC 464b ❑ 90 NONE ❑ 95 UNKNOWN ❑ 99 OTHER(Specify). 464c PIPING•TURBINE CONTAINMENT SUMP TYPE 1-SINGLE WALL ® 2 DOUBLE WALL ❑ 90,NONE 464d VI.VENT,VAPOR RECOVERY )AND RISER 1 FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT Lj I STEEL 0 4 FIBERGLASS Lj 10 RIGID PLASTIC 90 NONE Ej 99 OTHER(Specify) 464e 464c1 VENT SECONDARY CONTAINMENT 1 STEEL 0 4 FIBERGLASS 0 10,RIGID PLASTIC 0 90 NONE 0 99.OTHER(Specify) 464f 464n VR PRIMARY CONTAINMENT 1 STEEL. 0 4 FIBERGLASS 10 RIGID PLASTIC 0 90 NONE U 99 OTHER(Specify) 4646 464XI VR SECONDARY CONTAINMENT 0 1 STEEL 4 FIBERGLASS ❑ 10 RIGID PLASTIC 90 NONE C3 99.OTHER(Specify) 464h 464hl VENT PIPING TRANSITION SUMP TYPE 1.SINGLE WALL 2 DOUBLE WALL 0 90.NONE 464. RISER PRIMARY CONTAINMENT IN I STEEL U 4 FIBERGLASS ❑ 10 RIGID PLASTIC El 90 NONE Ll 99.OTHER(Specify) 4641 464'l RISER SECONDARY CONTAINMENT I STEEL 4 FIBERGLASS 0 10,RIGID PLASTIC 0 90 NONE El 99.OTHER(Specify) 464k 464k1 FILL COMPONENTS INSTALLED ® I.SPILL BUCKET 3.STRIKER PLATESOTTOM PROTECTOR C9 4.CONTAINMENT SUMP 451a< VIL UNDER DISPENSER CONTAINEN'I (UDC) CONSTRUCTION TYPE ❑ 1.SINGLE WALL N 2.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 469a CONSTRUCTION MATERIAL ❑ 1.STEEL ® 4.FIBERGLASS ❑ 10,RIGID PLASTIC ❑ ".OTHERS i ) 4696-c V1I1. CORROSION PRt?"TECTtON STEEL COMPONENT PROTECTION ❑ 2 SACRIFICIAL ANODE(S) ❑ 4 IMPRESSEDCURRENT ❑ 6.ISOLATION 448 JX.APPUOM, SIGNAT fRE 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 legal requirements. APPLICANT SIGNATU DATE 2-23-12 470 1 APPLICANT NAME(print) andy Edwards 471 APPLICANT TITLE Environmental COMPiiarleo Administrator 472 tiPCF!1ST-B-112 Rev.(12all(17)