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4 IED PROGRAM CONSOLIDATED FOFS TANKS r (tVUNDERGROUND STORAGE TANKS - T P G 1 � 40-1k p I (two pages r'fw �.� e_of Pag TYPE OF ACTION ❑1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE� C URE T C.: (Check one item only) ❑ 7 PERMANENTLY CLO,AD9NjSITEj 41 3 RENEWAL PERMIT (Specify reason-for local use only) (Specify reason-for local use only) 11it8 TANK REMOVED BUSINESS NAME(Sa a as FACILITY NAME or DBA-Doing Business As) FACILITY ID: 0 7-Eleven#32262 3 �t a 1 LOCATION WITHIN SITE(optional) 2360 Grant Line Rd., Tracy, CA O SGI�IPT�±�i�+t c(� cale� Irlc [�rr��e��gCa#ion of'th�4J ��t )� t�3(� m�but)dtn�5�Iftd I�11�dMaides'shall bd,,strbhh'i ted ttrthe IG A - a r TANK ID# 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yes ® No 434 1 .� p-SQ7-ZBakersfield If"Yes",complete one page for each compartment. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 7/1998 15,000 ADDITIONAL DESCRIPTION(For local use only) 438 F .3... , .I iii/... 1 1 1K "01!1TEN1.4' .• TANK USE 439 PETROLEUM TYPE 440 ®1. MOTOR VEHICLE FUEL ®1a. REGULAR UNLEADED ❑2. LEADED [15. JET FUEL (If marked complete Petroleum Type) ❑1b. PREMIUM UNLEADED ❑3. DIESEL [16. AVIATION FUEL [12. NON-FUEL PETROLEUM ❑1c. MIDGRADE UNLEADED ❑4. GASOHOL [199.OTHER [13. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441 CAS#(from Hazardous Materials Inventory page) 442 [14. HAZARDOUS WASTE Gasoline (Includes Used Oil) [195.UNKNOWN `, til TaNr�C E TYPE OF TANK Ell. SINGLE WALL ❑3.SINGLE WALL WITH [15. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) EXTERIOR MEMBRANE LINER [195. UNKNOWN 2. DOUBLE WALL ❑4. SIGNLE WALL IN VAULT [199. OTHER TANK MATERIAL-primary fank ❑1. BARE STEEL ❑3. FIBERGLASS/PLASTIC [15. CONCRETE ❑95. UNKNOWN 444 (Check one item only) [12. STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS ❑8. FRP COMPATIBLE W/ 99� �Ry REINFORCED PLASTIC(FRP) 100%METHANOL t At&'""(A TANK MATERIAL-secondary tank ❑1. BARE STEEL [13. FIBERGLASS/PLASTIC [15. CONCRETE ❑95. UNKNOWN 445 (Check one item only) ❑2. STAINLESS STEEL [14.STEEL CLAD W/FIBERGLASS [18. FRP COMPATIBLE ❑99.OTHER REINFORCED PLASTIC(FRP) W/100%METHANOL ❑5. CONCRETE [110.COATED STEEL TANK INTERIOR LINING ❑1.RUBBER LINED [:13.EPDXY LINING ❑5.GLASS LINING [195.UNKNOWN 446 DATE INSTALLED 447 OR COATING ❑2 ALKYD LINING ❑4 PHENOLIC LINING ❑6 UNLINED ❑99 OTHER (Check one item only) (For local use only) OTHER CORROSION ❑1 MANUFACTURED CATHODIC❑3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ❑4 IMPRESSED CURRENT ❑99 OTHER (Check one item only) ❑2 SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE(local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all ®1 SPILL CONTAINMENT 1998 that apply) 1 ALARM ®3 FILL TUBE SHUT OFF VALVE ®2 DROP TUBE 1998 El 2 BALL FLOAT ❑4 EXEMPT ®3 STRIKER PLATE 1998 !`!',TANkG.t EAK DETECTiQ descr the..moniioringpragra 4kats bmittedtothelocal age ncy.> IF SINGLE WALL TANK(Check all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Check one item only) ❑1 VISUAL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING(MTG) ❑1 VISUAL(SINGLE WALL IN VAULT ONLY) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE ®2 CONTINUOUS INTERSTITIAL MONITORING ❑3 CONTINUOUS ATG ❑7 GROUNDWATER ❑3 MANUAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑8 TANK TESTING +(SIR) BIENNIAL TANK TESTING ❑99 OTHER 11/:TANK CLQSiIR NFQ 1!C} PERMANEN IREINI AGE 455 ESTIMATED QUANTITY OF SUBSTANCE 456 457 ESTIMATED DATE LAST USED(YR/MO/DAY) TANK FILLED WITH INERT MATERIAL? REMA-?/.2-?� s--/ D 3 gallons ❑Yes ❑ No UPCF(1/99 revised) • ` Formerly SWRCB Form B