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0 UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK 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 I,II,111,IV,and IX below) 430 ❑ 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ® 5.CHANGE OF INFORMATION 6.TEMPORARY UST CLOSURE El 7.UST PERMANENT CLOSURE ON SITE 8,LIST REMOVAL. DATE UST PERMANENTLY CLOSED: 430. I DATE EXISTING UST DISCOVERED; 430b I. FACILITY INFORMATION FACILITY ID#(Agcncv Use Only) 1. l BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 Pacific Bell Telephone Company dba AT&T Califomia UE046 BUSINESS SITE ADDRESS 03 CITY 104 907 Lincoln Road Stockton II.TANK DESCRIPTION TANKID# 472 TANK MANUFACTURER 433 TANK CONFIGURATION: THIS TANK IS 434 1158 rT/q(;f54C>bca3 MODERN WLD ®I.ASTAND-ALONE TANK ❑2.ONE IN A COMPARTMENTED LIN IT. Complete one page for each companrnent in the unit. DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437 1997 4000 1 M.TANK USE AND CONTENTS TANK USE ❑ la.MOTOR VEHICLE FUELING ❑ Ib.MARINA FUELING ❑ Ic.AVIATION FUELING 439 ❑ 3.CHEMICAL PRODUCTSTORAGE ❑ 4.HAZARDOUS WASTE(Include.Used Oil) ❑ 5.EMERGENCY GENERATOR FUEL IHSC§2528L51c)) ® 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 (Specify): 440a NON-PETROLEUM: 7.USED OIL ❑ 10.ETHANOL ❑ 11.OTHER NON-PETROLEUM(Specify): 446b IV. TANK CONSTRUCTION TYPE OF TANK ❑ I SINGLE WALL ® 2.DOUBLE WALL ❑ 95.UNKNOWN 443 PRIMARY CONTAINMENT ® 1.STEEL ❑ 3.FIBERGLASS ❑ I. INTERNAL BLADDER 444 ❑ 7.STEEL t INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (S eci'): 444. SECONDARY CONTAINMENT ❑ 1.STEEL ID 3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445 ❑ 90.NONE ❑ 95.UNKNOWN [199.OTHER(Specify): 445. OVERFILL PREVENTION ® I.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 ❑I.SINGLE-WALLED ®2.DOUBLE-WALLED ❑99.OTHER 460 SYSTEM TYPE ❑ 1.PRESSURE ❑ 2.GRAVITY ® 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION 123 CCR§2636(.X3)) ase PRIMARY CONTAINMENT ❑ I.STEEL ® 4.FIBERGLASS 0 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 PIPINGIfURBINE CONTAINMENT SUMP TYPE ® L SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 4644 VI.VENT,VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT 1.STEEL 0 4.FIBERGLASS 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464e 464.1 VENT SECONDARY CONTAINMENT ❑ I.STEEL 0 4.FIBERGLASS 10.RIGID PLASTIC ® 90.NONE ❑ 99.OTHER(Specify) 464f 464fl VR PRIMARY CONTAINMENT 1.STEEL 4.FIBERGLASS 10.RIGID PLASTIC ® 90.NONE. 99.OTIIER(Specify) 4646 464 1 VR SECONDARY CONTAINMENT 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC 0 90.NONE ❑ 99.OTHER(Specify) 464h 464h1 VENT PIPING TRANSITION SUMP TYPE 1.SINGLE WALL EI 2.DOUBLE WALL 0 90.NONE 464, RISER PRIMARY CONTAINMENT 0 I.STEEL Lj 4.FIBERGLASS Ij 10.RIGID PLASTIC 90.NONE ❑ 99.OTHER(Specify) 464) 464j I RISER SECONDARY CONTAINMENT 0 1.STEEL 0 4.FIBERGLASS 10,RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 4641, 4641,1 FILL COMPONENTS INSTALLED 0 I.SPILL BUCKET ® 3.STRIKER PLATE/BOTTOM PROTECTOR 0 4.CONTAINMENT SUMP 451a-c VII.UNDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE ❑ 1.SINGLE WALL ❑ 2.DOUBLE WALL ® 3.NO DISPENSERS ❑ 90.NONE 469a CONSTRUC'T'ION MATERIAL. ❑ I.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99.OTHER(Specify) 4o9b-c VIII. CORROSION PROTECTION STEEL COMPONENTPRO1FCTlON ❑ 2 SACRIFIC IAL ANODES) ❑ 4.IMPRESSED CURRENT 6 ISOLATION a4s IX. APPLICANT SIGNATURE CERTIFICATION: I certify that this LIST 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 SIGNATURE a" DATE 476 6/3/2008 APPLICANT NAME(print) 471 APPLICANT TITLE 472. Steven J Hall Manager, EH&S UPCF UST-B-1/1 Rev.(12/2007)