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FIED PROGRAM CONSOLIDATED FO UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION TANK INFORM U ) TYPE OF ACTION (Check one item only. For a UST closure or removal,complete only this section and Sections I,11,111,IV,a o 430• ❑ 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ® 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE El 7.UST PERMANENT CLOSURE ON SITE [18.UST REMOVAL 2 N DATE UST PERMANENTLY CLOSED: 430a. DATE EXISTING UST DISCOVERED: 430b. I. FACILITY INFORMATION EWRONMENTAL HEALTH FACILITY ID#(Agency Use Only) PE 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 IS 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. TANK USE AND CONTENTS TANK USE ® la.MOTOR VEHICLE FUELING ❑ lb.MARINA FUELING ❑ lc.AVIATION FUELING 439. ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(Includes Used Oil) ❑ 5.EMERGENCY GENERATOR FUEL[HSC 125281.5(c)] ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 439a. .....................".................................................................................................... CONTENTS PETROLEUM: ❑ la.REGULAR UNLEADED ❑ IC.MIDGRADE UNLEADED ❑ 1b.PREMIUM UNLEADED 4ao. ® 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS .............................................................-........._. ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM(Specify): 440a. ...................................................................................................................................................................................................._................................. .................. ....I....................... NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL ❑ 11.OTHER NON-PETROLEUM(Specify): 440b. IV. TANK CONSTRUCTION TYPE OF TANK............................................................._❑..._1.:._SINGLE WALL......_®..._2.DOUBLE WALL.........__❑..._95:.UNKNOWN....................... 443. PRIMARY CONTAINMENT ❑ I.STEEL ® 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 444. ........................❑....7:._STEEL+INTERNAL LINING [195.UNKNOWN ❑ 99.OTHER(Specify): 444a. SECONDARY CONTAINMENT ❑ I.STEEL ®3.FIBERGLASS [16.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445. ....................................................... ❑ 90.NO ❑ 95.UNKNOWN ❑99.OTHER_ (Specify): 445a. 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 PIPING CONSTRUCTION PIPING CONSTRUCTION ❑ 1;SINGLE WALL ® 2_DOUBLE WALL ❑ 99.OTHER 460. ....................................................................................................................... SYSTEMTYPE ................................................................................................................................................................................................................................__.............................................................................................. ....._........................._®..._1.:._PRESSURE.................._❑..._2:._GRAVITY..............................._❑..._3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION[23 CCR 12636(a)(3)] 458. PRIMARY CONTAINMENT ❑ L STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE...............................................................❑ 10.RIGID PLASTIC ........................................................................464. ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 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 p 2.DOUBLE WALL ❑ 90.NONE 4641. VI. VENT,VAPOR RECOVERY(VR) AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): 464e. ................................................................................................................................................................................................................................_.._.._...................................................................................................................................................................................................................................................................... 464e1. VENT SECONDARY CONTAINMENT ❑ 1.STEEL [14.FIBERGLASS [I 10.10.RIGID PLASTIC ® 90.NONE ❑ 99.OTHER(Specify): 464£1. ........................................................................................ ....................... VR PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ (Specify):99.OTHER 464g. .. �..: aha 1. VR SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE ❑ 99.OTHER(Specify): 464h. 464h i. VENT PIPING TRANSITION SUMP TYPE ❑ 1.SINGLE WALL ❑ 2.DOUBLE WALL ® 90.NONE 464'. ......................................................................................_..............._.............................................................................................................................................__.._...............__............_......_............._................__..__.._........................................................................-............ RISER PRIMARY CONTAINMENT ❑ 1.STEEL _® 4.FIBERGLASS ❑ 10.RIGID PLASTIC [1 90.NONE El 99.OTHER(Specify): 464j. .........._ ........................................... ....... aha'I. _ .........................................._................................. . . . . RISER SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE [1 99.OTHER..Specify): 464k. . _ _ ........................................................................................................................................................ ... 464k1. FILL COMPONENTS INSTALLED ® 1.SPILL BUCKET ® 3.STRIKER PLATE/BOTTOM PROTECTOR ❑ 4.CONTAINMENT SUMP 451a-c. VII. UNDER DISPENSER CONTAINMENT (UDC) CONSTRUCTION TYPE ® 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 3.NODISPENSERS [_-] 90.NONE 469a. ....... ..........................................-......................................._..........._........................................................................................................................................................................................................................................_..........._............................................................ ...................... .................................................................................................................................... CONSTRUCTION MATERIAL ❑ 1.STEEL ❑ 4.FIBERGLASS ® 10.RIGID PLASTIC ❑ 99.OTHER(Specify) 469b. 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 in full compliaW with legal requirements. APPLICANT SIGNATURE DATE �2 a7o. 41- APPLICANT NAME(print) G rge rkee 471. APPLICANT TITLE Plant Eriglrieerlrig f�l eaager 472 UPCF UST-B Rev.(12/2007)-1/2 www.unidoes.org