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�� "".�."""'. .✓ f£ ani y�c �/ hr �In <br /> r/i <br /> CHEVRON#208117** CERs ID <br /> ss 5 TRACY BLVD 10182313 <br /> RACY,CA 95376 <br /> ,.ii...��♦ . F / <br /> Submiteal Stattl5 «, N/ <br /> { m <br /> Submitted on 3/31/2015 by Charles Bittle of Chevron Products Company(A Division of Chevron U.S.A.Inc.)(San Ramon) <br /> Comments by submitter:Per the request on the 2/23/2015 UST Inspection report,I am resubmittingthe UST element with revised forms.If you have questions or if <br /> further action is necessary,please contact Charles Bittle at cbittle@chevron.com or call 925-842-9002. <br /> yi3e E3 ACt14n ; / x <br /> Type of Action(UST Tank) <br /> (Confirmed/Updated Information _ <br /> aclity Information <br /> CHEVRON#208117** <br /> 55 S TRACY BLVD <br /> RACY,CA 95376 <br /> aT1l�Descrilon ` yi <br /> ,y/ <br /> Tank ID# Date UST System Installed Tank Configuration <br /> A0508092 9/1/1998 A Stand-alone Tank <br /> Tank Manufacturer Date Existing UST Discovered Number of Compartments in the Unit <br /> ERXES l <br /> Tank Capacity In Gallons Date UST Permanently Closed Additional Description <br /> 15000 Tl-SUPREME(PER VEEDER ROOT <br /> ...........Y......_......_...................._......_. PROGRAMMINGL <br /> Fatk Use alnd Contents' <br /> enk Ganstrcton <br /> Tank Use Tank Contents Type of Tank <br /> Motor Vehicle Fueling, Premium Unleaded Double Wall <br /> Other Petroleum Contents Primary Containment j Secondary Containment <br /> Fiberglass Fiberglass <br /> Other Non-Petroleum Contents <br /> veMil Protection <br /> Audible/Visual Alarms Yes Fill Tube Shut-Off Valve <br /> Rail Float Exempt <br /> roduct/Waste Piping Construction' mm <br /> . 77777 <br /> _ ti: . <br /> Piping Construction Primary Containment Secondary Containment I Piping/Turbine Containment Sump <br /> Double-walled Fiberglass Fiberglass 1 Single-walled`-` <br /> Piping System Type <br /> Pressure <br /> ' ` <br /> etr Vapor Recovery <br /> (VR)and Riser/Fill Pipe Piping Gonsteueti�onF..,. <br /> :. <br /> Primary Containment Vapor Recovery Primary Containment Riser Pipe Primary Containment Vent Piping Transition Sumps <br /> Fiberglass Fiberglass Steel i'None <br /> Fill Components Installed <br /> Secondary Containment Vapor Recovery Secondary Containment Riser Pipe Secondary Containment Yes Spill Bucket <br /> None None s Fiberglass Yes Striker Plate/Bottom Protector <br /> Yes Containment Sump <br /> mv <br /> nder t?is ser Corttainmen/UDC F orrrsiar#Pr to o :. <br /> f ( , <br /> Construction Type Construction Material Sacrificial Anode <br /> Ingle-walled Fiberglass Impressed Current <br /> Yes Isolation <br /> Iicant Certification 7 a y � <br /> N <br /> Applicant Name Applicant Title Date Certified <br /> ARLES BITTLE RETAIL HES 2/3/2014 <br /> Printed on 3/31/2015 6:51 PM <br />