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Allk Alk d I!A UWMD PROGRAM CONSOLIDATED IPORW�- UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION - TANK INFORMATION (o- Ii- I- Us7) TYPE OF ACTION (Check one dow only. For a UST clamm ar>rmmu4 aot Wkie only tits section and Sections I, A 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 ❑ 9. UST REMOVAL HL'i K= ill CONTENTS: TANK USE ® 1& MOTOR VEHICLE FUELING ❑ 'ib. MARINA FUELING ❑ 1c. AVIATION FUELING 439. ❑ 3. CHEMICAL PRODUCT STORAGE ❑ 4. HAZARDOUS WASTE Omdada Used Oil) ❑ 5. EMERGENCY GENERATOR FUEL [FISC §25251.5(.)) ❑ 6. OTHER GENERATOR FUEL ❑ 95. UNKNOWN ❑ 99 OTHER (Spa*): 439& CONTENTS PETROLEUM: ❑ I& REGULAR UNLEADED ❑ 1a MIDGRADI: UNLEADED ❑ Ib. PREMR)M UNLEADED 440. ® 3. DIESEL ❑ 5. JET FUEL ❑ 6. AVIATION GAS ❑ s. PETROLEuM BLEND FUEL ❑ 9. oTH m P'ETRoLEUM (Specify)- 440& NON -PETROLEUM: ❑ 7. USED OLL ❑ 10. ETHANOL ❑ 11. OTHER NON -PETROLEUM 440b. IV. TANK CONSTRUCTION TYPE OF TANK ❑ i. SINGLE WALL ® 2. DOUBLE WALL ❑ 95. UNKNOWN 443. PRIMARY CONTAINMENT ❑ L STEEL. q 3. FIBERGLASS ❑ 6. INTERNAL BLADDER 444. ❑ 7_ STEEL + INTERNAL LINING ❑ 95. UNKNOWN ❑ 99.OlIMM (Specify): 444& SECONDARY CONTAINMENT ❑ 1. STEEL ® 3. FIBERGLASS ❑ 6- EXTERIOR MEMBRANE LINER ❑ 7_ JACKETED 445. ❑ 90. NONE ❑ 95. UNKNOWN ❑ 99.OTIIER (Specify): 445x. OVERFILL PREVENTION 10 i_ AUDIBLE & VISUAL ALARMS ® 2.8ALI. FLOAT ❑ 3. FILL TUBE SHUT-OFF VALVE 452. ❑ 4. TANK MEETS FOR EXEMW1ION FROM OVERFILL PREVENTION EOUHIMMENT Y. YK i U[--- / WA�f 1a1: Y#Yll�itr CONSTftUCTIO - PIPING CONSTRUCTION ❑ 1. SINGLE WALL ® 2. DOUBLE WALL ❑ 99- OTHER 4W SYSTEM TYPE ® L PRESSURE ❑ 2. GRAVITY ❑ 3. CONVENTIOPIAL SUCTION ❑ 4. SAFE SUCTION (23 CCR §2636(a I 458. PRIMARY CONTAINMENT ❑ 1. STEEL ❑ 90. NONE 0 4- FIBERGLASS ❑ 95_ UNKN OA N ❑ 3. FLEXIBLE ❑ 10. RIGID PLASTIC ❑ 99.OTHER (Specify): 464& 464. SECONDARY CONTAINMENT ❑ 1. STEEL 0 90. NONE ® 4. FIBERGLASS ❑ 95. UNKNOWN ❑ 9. FLEXIBLE ❑ 10. RIGID PLASTIC ❑ 99. OTHER (Specify): 464.. 4646- PIP1NGlTURBINE CONTAINMENT SUMP TYPE ® 1. S[NGLE WALL ❑ 2. DOUBLE WAIL ❑ 90. NONE 4&k VI. VENT, VAPOR RECOVERY (VR) AND RISER I FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT ❑ L STEEL. 9 4_ FIBERGLASS ❑ 10. RIGID PLA.SITC ❑ 90. NONE ❑ 99. OTHER (Specify): 464e. 464e1. VENT SECONDARY CONTAINMENT ❑ 1. STEEL [14, FIBERGLASS ❑ 10_ RIGID PLASTIC ® 90. NONE 099. OTHERSpd&. 464f 464. fl VR PRIMARY CONTAINMENT ❑ 1. STEEL ® 4. FIBERGLASS ❑ 10_ RIGID MASTIC ❑ 90. NONE ❑ 99.OTHER (Specify): 4�s VR SECONDARY CONTAINMENT ❑ 1 _ STEEL ❑ 4_ FIBERGLASS ❑ 10. RIGID PLASTIC ® 90. NONE ❑ 99. OTHER (Spocify): 464k 464h1. VENT PIPING TRANSITION SUMP TYPE ❑ I_ SINGLE WALL ❑ 2. DOUBLE WALL ® 90. NONE 464L RISER PRIMARY CONTAINMENT ® L STEEL ❑ 4. FIBERGLASS ❑ 10. RIGIDPL.ASLIC ❑ 9o. NONE ❑ 99.OTHER (Specify): 46 of RISER SECONDARY CONTAINMENT ❑ 1. SUET. ❑ 4_ FIBERGLASS ❑ 10. RIGID PLASTIC 0 9o. NONE ❑ 99. OTHER (Specify): 464k. FILL COMPONENTS INSTALLED ® L_ SPILL BUCKET ® 3. STRIKER PLATEMOT OM PROTECTOR ElMP 4- CONTAINMENT SU 4456t4k�t. VII. UNDER DISPENSER, �tJNTA N ANT "C) CONSTRUCTION TYPE ® L SINGLE WALL ❑ 2. DOUBLE WALL ❑ 3. NO DISPENSERS ❑ 90. NONE 469a. CONSTRUCTION MATERIAL ❑ 1. STEEL ❑ 4. FIBERGLASS ® 10. RIGID PLASTIC ❑ 99.OTHER (Specify) 469b. 46%- CORRflSIfi)I PRATE£' - ON STEEL COMPONENT PROTECTION 0 2. SACRIFICIAL ANODES) 0 4_ IMPRESSED CURRENT 26. ISOLATION 448.