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P y ? UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK g1 0 OPERATING PERMIT APPLICATION-TANK INFORMATION(One form per US TYPE OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections 1,11,DI,IV,and LY below) 430 ® I.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: 4303 DATE EXISTING UST DISCOVERED: 4306 1. FACILITY_ INFORMATION FACILITY ID A(Agency Use Onl)) t F I A �_-�� 010 10 0 0 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) Tesoro West Coast Company, LLC#68150 BUSINESS SITE ADDRESS 103 CITY 104 13975 E.Hw 88 Lockeford,Ca 95237 II.TANK DESCRIPTION TANK ID k 0010 432 TANK MANUFACTURER 433 TANK CoNFIGURAT1oN: THIS TANK IS 434 Xerxes ❑1.A STAND-ALONE TANK ®2.ONE IN A COMPARTMENTED UNIT. Com kte one page for each c mens in the unit. DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS A30 NIIAIBER Of COMPARTMENTS IN Tl It:UNIT 437 2012 (TUN N 8000 Two III.TANK USE AND CONTENTS TANK USE ® la.MOTOR VEHICLE FUELING ❑ Ib MARINA FUELING ❑ Ic AVIATION FUELING 439 ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(looludef lixd Oil) ❑ 5 EMERGENCY GENERATOR FUEL[tiSC§25281 5(01 ❑ 6,OTHER GENERATOR FUEL ❑ 95 UNKNOWN ❑ 99.OTHER (Specify): 439a 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 (5 iA): 4404 NON-PETROLEUM:❑ 7 USED OIL ❑ 10.ETHANOL ❑ 11,OTHER NON-PETROLEUM(S ifv)_ p IV. TANK CONSTRUCTION TYPE OF TANK ❑ I SINGLE WALL ® 2.DOUBLE WALL. ❑ 95.UNKNOWN 443 PRIMARY CONTAINMENT ❑ 1 STEEL N 3-FIBERGLASS ❑ 6.INTERNAL BLADDER 444 ❑ 7.S7 EEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (S ci ): 444a SECONDARY CONTAINMENT ❑ I.STEEL N 3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7 JACKETED 445 ❑ 90.NONE ❑ 95.UNKNOWN [199.OTHER(Specify). 445. OVERFILL PREVENTION ® L AUDIBLE&VISUAL ALARMS Lj 2.BALL FLOAT N 3.FILL-TUBE SHUT-OFF VALVE 452 ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT/WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION ❑1,SINGLE-WALLED ®2.DOUBLE-WALLED ❑99,OTHER 460 SYSTEM TYPE ® 1-PRESSURE ❑ 2.GRAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION 123 CCR§2630.)(3) 458 PRIMARY CONTAINMENT ❑ 1 STEEL ® 4 FIBERGLASS ❑ 8 FLEXIBLE ❑ 10 RIGID PLASTIC 464 ❑ 94l NONE ❑ 95 UNKNOWN ❑ 99 OTHER(S cify): 464. SECONDARY CONTAINMENT ❑ I STEEL. ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10 RIGID PLASTIC 464b ❑ 90.NONE- ❑ 95.UNKNOWN ❑ 99.OTHER(Speeify) 4&k PIPING/TURBINE CONTAINMENT SUMP TYPE ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 90 NONE 4644 VI.VENT,VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT Lj I STEEL 0 4 FIBERGLASS 10.RIGID PLASTIC ❑ 90.NONE C1 99.OTHER(Specify) 4641 464e1 VENT SECONDARY CONTAINMENT 0 1 STEEL ® 4 FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE 99.OTHER(Specify) 404( 464n VR PRIMARY CONTAINMENT ❑ 1 STEEL ® 4 FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90 NONE ❑ 99.OTHER(Specify) 4648 464 1 VR SECONDARY CONTAINNIFNT 13rEFl_ 0 4 FIBERGLASS 10 RIGID PLASTIC 90 NONE 99.OTHER(Specify) 464h 464h1 VENT PIPING TRANSITION SUMP TYPE ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 90.NONE 464i RISER PRIMARY CONTAINMENT ® 1-STEEL ❑ 4 FIBERGLASS ❑ 10 RIGID PLASTIC ❑ 90.NONE 99.OTHER(Specify) 4641 46411 RISER SECONDARY CONTAINMENT ❑ 1 STEEL 0 4 FIBERGLASS ❑ III.RIGID PI-ASTIC ® 90.NONE ❑ 99 OTHER(Specify) 464k 464k l FILL COMPONENTS INSTALLED ® 1 SPILL BUCKET ® 3.STRIKER PLATE;BOTTOM PROTECTOR 0 4.CONfAINMEtYr SUMP 4512-c VII.UNDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NONE 409. CONSTRUCTION MATERIAL ❑ 1.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99.OTHER(Specify) r.--.._ 469b-c VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT ❑ 6 ISOLATION ,' 446 M. APPLICANT SIGNATURE CERTIFICATION: 1 certify that this UST system is compatible with the hazardous substance stored and that the information provided herein is trur;accuratq and in full compliance with legal requirements. APPLICANT SIGNATUR DATE 2-23-12 azo. APPLICANT NAME(print) andy dwards 471 APPLICANT TITLE Environmental Compliance Administrator 472' g r UPCF LIST-B-112 Rev.(1:12007)