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Google Maps https://maps.google.com/maps?q=lodi&ie=U'rF-8&hq=&hneax--Ox8O kc Tn nnn nll ihr.i•4 niniln+hn4 nrn siinihln nn 4hn vCJ1 7 UNIFIED PROGRAM CONSOLIA E G 0 UNDERGROUND STORAGE TANK L�ERATING PERMIT APPLICATION-TANK INFORMATION (one form per UST) (7 e [ A -' TYPE OF ACTION (Check one item only. For a UST closure or removal,complete only this section and Seclions 1,IL 111,IV.mrd IX below) 430 !�J l GRANGS 0. 6.TEMPORARY UST CLOSURE 7.UST PERMANENT CLOSURE ON SITZ, 8.UST REMOVAL .x DATE UST PERMANENTLY CLOSED: 4300.• DA'�t'r�IrX�I�G UST DISCOVERED: 4306• � I; FACILITYV r. TION FACILITY ID#(Agency Use Orly) - )•.:_ BUSINESS NAME(Scone as Facility Name or DBA-Doing Business As) 3. G 13USINESS SlTrLADDS i 103 CITY 104. TANK Ill tl 432 TANK MANUFACTURER433• TA K CONFIGURATION:THIS'fANK IS 434. SJ- q A34.A STAND-ALONE TANK C0.0.1c one pto Mh t I I t i-I JV age tg 2.ONE IN A COMPARTMENTED UNIT a gupnimcnt in lhCuOIL 'DATE USTSYS'IEM INSTALLED 435• TANK CAPACITY.JN G LLONS 436 NUMBER Ol Iv()R 1 MCNTS IN THE UNIT 437• U TANK USEh.MOTOR VEHICLE:FUELING [I lb.MARINA FUELING ❑ Ic.AVIATION FULLING 439. ❑3.CHEMICAL PRODUCT STORAGE ❑4.HAZARDOUS WASTE(Ndudes Used Oil) ❑5.rAAERGLNCY GENERATOR FUEL(HSC¢25281.5(-)) _❑6.OTHCRGENERATORFUEL ❑95.UNKNOWN ❑99.OTHER(St fc 4393. CONTENTS PETROLEUM- C214a.REGULAR UNLEADED -❑ lc.MIDGRADC•UNLEADED y-❑ Ib.PREMIUM UNLEADED 440. ❑ 3.DIESEL ❑S.3Er FUEL ❑ 6.AVIATION GAS _..__....__.--_.___.____.__ _---•-.-M--:[- -0 SPETI(OLEUMBLlsNUFUEL-.0 9.OTIif:RPETROLEU(Spec ify).c 4401 NON-PETROLEUM: 17-.'-USED 0 1 L ❑ 10.ETHANOL ❑ 11.OTHER NON-PETROLEUM(Specify): 44eb. -wMa :i :TQJNK:C4tTItiCTION ;`': : TYPE OF TANK JNGLE WALL [I 2.DOUBLL WALL []95.UNKNOWN _ _ __--__ -- -- 443• PRIMARY CONTAINMENT STEEL ❑3.FIBERGLASS 0 6.INTERNAL BLADDER 444. ❑ 7.STEEL+INTERNAL LINING 0_95.UNKNOWN ❑99.OTHER(Specify): 4440. SECONDARY CONTAINMENT ❑ STEEL [__1 FIBERGLASS ❑6 LX'I'FAtIOR MEMBRANE LINER ❑ 7.JACKETF� 445. .NONE ❑95.UNKNOWN ❑99.OTHER(Specify_ 4450. OVERFILL PREVENTION ❑ 1.AUDIBLE&VISUAL ALARMS ❑2.BALL FLOAT ❑3.PILL TUBE SHUT-OFF VALVE 45z. 4.TANK MEETS REOUIREMEM S FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT />?E' STE PIPIT .�()NS 'I1CTION PIPING CONSTRUCTION SINGLE WAIL ❑2.DOUBLE WALI, ❑99.On mit 460. SYSTEM TYPE 1.pRESSURL ❑2.GRAVITY -$'J.CONVENTIONAL SUCTION 0 4.SAFE SUCTION i23 CCR 1263G(a�p)J _PRIMARY CONTAINMENT STEEL [14.FIBERGLASS - [3 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464 ❑90.NONE 0 95.UNKNOWN ❑ 99.OTHER(,Sify): 4640. SECONDARY CONTAINMENT p1.STEEL �❑4.FIBERGLASS ❑ 5.FLMBLE ❑ 10.RIGID PLASTIC - 4646. t O - ❑95.UNKNOWN ❑99.OTHER(Specify)_- .� �� 464c. PIPING/TURBINE CONTAINM NT SUMP TYPE - [31.SINGLE WALT, [32.DOUBLE WALL NONE A6od KEOVE$Y{ j 1D RIS �t/FILL PIpIPINC CONSTAR( CT101V VENT PRIMARY CONTAINMENT Qf4.STEEL ❑4.FIBERGLASS ❑ 10.RIGID PLASTIC NONE ❑99.OTHER(S `- ----------�if-Y�-. 464-I. VENT SECONDARY CONTAINMENT ❑ 1.STEEL ❑4.FIBERGLASS ❑ 10.RIGID PLASTIC �0.NONE ❑99.OTHER(Specify): 464n. --_------...__-__......__...__..._._-:._-_--------._..._-.-----------.---_---.-----_.__.... VR PRIMARY CONTAINMENT ❑ 1.STEEL ❑4.FIBERGLASS ❑ 10.RIGID PLASTIC 4a'y0.NONE ❑99.OTHER(Specify): 446 f: - __... --------------------- ----- - - _ _._.... - ------- ...----- --- VR SECONDARY CONTAINMENT ❑ 1.STEEL ❑4.FIBERGLASS ❑ 10.RIGID PLASTIC 0.NONE, ❑ 99.OTHER(Specify): 46 464R VNT PIPING TRANSITION SUMP TYPE ❑ I.SINGLE WALL [1 )x' 2.DOUBLE WALL 40.NONE i7464i.C• RISER PRIMARY CONTAINMENT ❑ I.sTEEL ❑4.FIBERGLASS ❑ 10.RIGID PLASTIC .NONE ❑99.0TIIER(Specify): 464il._ RISER SECONDARY CONTAINMENT ❑ 1.STEEL ❑4.FIBERGLASS ❑ 10.RIGID PLASTIC NONE ❑99.OTHER(Specify): 46441. FILL COMPONENTS INSTALLED ❑ 1.SPILL BUCKET [13.STRIKER PLATEAOTTOM PROTECTOR ❑4.CONTAINMENT SUMP 4513-. _CONSTRUCTION TYPIi_ _ -_-,[�hS1 GLE WALT - - - ❑2.DOUBLE WALL Q 3_NO DISPENSERS NONE. ' CONSTRUCTION MATERIAL ❑ 1.STEEL ❑4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑99.OTHER(Specify) 144. VIII G4RRQSION I' tTE `TON. STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODES ❑4.IMPRESSED CURRENT ❑6.ISOLATION 448. TX AYP7,ICANT;SIGNA�'URE: .'=.°; CERTIFICATION:I certify that this UST 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 DATE 3 470 APPLICANT NAME(print) ° ' APPLICANT TITLE 4n UPCF UST-0 Rev.(1212007)-112 www.unidocs.org