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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION TANK INFORMATION (One form per UST) TYPE OF ACTION (Check one item only. For a UST 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: 430a. DATE EXISTING UST DISCOVERED: 430b. I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) 1. BUSINESS NAME(Same as Facility Name or DBA Doing Business As) 3. United Parcel Service Inc., an Ohio Corporation BUSINESS SITE ADDRESS 103. CITY 104. 1532 North Broadway Stockton II. TANK DESCRIPTION TANK ID# 432. TANK MANUFACTURER 433. TANK CONFIGURATION:THIS TANK 1S 434. T-1 Owens Corning ® 1.A STAND-ALONE TANK Complete one page for each ❑ 2.ONE IN A COMPARTMENTED UNIT compartment in the unit. DATE UST SYSTEM INSTALLED 435. TANK CAPACITY IN GALLONS 436. NUMBER OF COMPARTMENTS IN THE UNIT 437. 12/15/1987 10,000 1 III. TANKUSEAND CONTENTS TANK USE ® la.MOTOR VEHICLE FUELING ❑ Ib.MARINA FUELING ❑ lc.AVIATION FUELING 439. ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(Includes Used Oil) ❑ 5.EMERGENCY GENERATOR FUEL[HSC I25281.5(c)] ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 439a. CONTENTS PETROLEUM: ❑ la.REGULAR UNLEADED ❑ lc.MIDGRADB UNLEADED ❑ Ib.PREMIUM UNLEADED 440. ® 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑..._$.r..PETROLEUM BLEND FUEL....._....._❑...�.OTHER PETROLEUM(Specify): 440a. .......................................................................................... NON-PETROLEUM:[17.USED OIL E] 10.ETHANOL ❑ 11.OTHER NON-PETROLEUM(Specify): 440b. IV. TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLEWALL ® 2.DOUBLE WALL ❑ 95.UNKNOWN 443, PRIMARY CONTAINMENT ❑ I.STEEL ® 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 444. ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 444a. SECONDARY CONTAINMENT ................................................................. ...... ......................................................................................... . .............................................................................................p..........Y....... .................................................. ❑ 1.STEEL ®3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445. ❑....90.NONE ❑ 95.UNKNOWN ❑99.OTHER(Specify): 445a. ........................................._................................Pe.......Y) 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/WASTE PIPINGCONSTRUCTION PIPING CONSTRUCTION ❑ I.SINGLE WALL ® 2 DOUBLE WALL ❑ 99.OTHER 460. ....... ......._. . SYSTEM TYPE _................................................................................................................................................................................................................................................ ® 1.PRESSURE ❑ 2.GRAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION[23 CCR I2636(a)(3)] 458. .. .. .. .... ..................... ......... .... .. ...... ..... .... ...... .. ... ® 4.FIBERGLASS ❑ 8.FLEXIBLE 464...... PRIMARY CONTAINMENT ❑ 1.STEEL ❑ 10.RIGID ........................ ❑...90.NONE................................❑..._9.5.:._UNKNO WN'.....................❑....99:.OTHER(Specify).'...... 464a. SECONDARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ lO.RIGIDPLASTIC464b. ....................................................................._............................_❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464c. PIPING/TURBINE CONTAINMENT SUMP TYPE....................® I.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 464x: VI. VENT, VAPOR RECOVERY(VR)AND RISER/`FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT ❑ 1.STEEL ® ❑ I0.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER 4.FIBERGLASS 464e. _ . . . _._........- . . - _ . _ .......................................................-.............................................................__......._.................... ............................................................................................. ... 464e1. VENT SECONDARY CONTAINMENT ❑ I.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE [199.OTHER(Specify): 464E VR PRIMARY CONTAINMENT ❑ L STEEL ® 4.FIBERGLASS ❑ 10 RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): 4644g ....1........ ............ .. ............ ...................... .. ... .. ... ..........k.......... .. ......1 .. 464h. VR SECONDARY CONTAINMENT ❑ L STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE ❑ 99.OTHER(Specify):. 46411 VENT PIPING TRANSITION SUMP TYPE ❑ 1.SINGLE WALL. [1 2.DOUBLE WALL ® 90.NONE 464,. .. . .. ........................................................... . ............... _. ................................................................................... ............._....... ....................._......................._......_.........................._...-.....................................................................__...._..............................................__.........._................ ................................................................................................. RISER PRIMARY CONTAINMENT ❑ 1 STEEL ® 4.FIBERGLASS [110.RIGID PLASTIC [190.NONE ❑ 99.OTHER(Specify): 46441. ..........J.......... RISER SECONDARY CONTAINMENT k ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE ❑ 99.OTHER 464k1. FILL COMPONENTS INSTALLED ® I.SPILL BUCKET ® 3.STRIKER PLATE/BOTTOM PROTECTOR ❑ 4.CONTAINMENT SUMP 451 a-c. VII. UNDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE ® L SINGLE WALL ❑ 2.DOUBLE WALL ❑ 3.NO DISPENSERS 469a. ..... _-....... ............ ❑ 90 NONE CONSTRUCTION MATERIAL ❑ 1.STEEL ❑ 4.FIBERGLASS ® 10.RIGID PLASTIC ❑ 99.OTHER(Specify) 469ti. 469c. VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT ❑ 6.ISOLATION 448. IX. APPLICANT SIGNATURE CERTIFICATION: 1 certify that this UST system is compatible with the hazardous substance stored and that the information provided herein is true, accurate,and'n full compliance with legal requirements. APPLICANT SIGNATURE DATE 470 APPLICANT NAME(print) or urkee 471. APPLICANT TITLE Plant Engineering Area Manager 472.