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FIED PROGRAM CONSOLIDATED FO TANK, TA PR#: P UNDERGROUND STORAGE TANKS - TANK G �t� FAC#: F Q4QQI (two pages per tank) TYPE OF ACTION ❑ INEW SITE PERMIT 4AMENDED PERMIT Page6of] (CAmkmlyilenmly) ❑ ❑ SCHANGE OF INFORMATION ❑ 6TEMPORARY SITE CLOSURE (Spec 6 rwsan-(laal m - '- ❑ 7 PERMANENTLY CLOSED ON SITE X3 RENEWAL PERMIT eonlYl (sPxrry reason-f rl«sl use only) ❑ STANK REMOVED 430 BUSINESS NAME(sameas FACIUTYNAMEorNA-Ixias Oml111em A.) FACILITY IU: PR I EMIL'S LIQUOR&SPORTS SHOP* FA0000306 PR0231485 LOCATION WITHIN SITE(opdom0 1405 CALIFORNIA ST,ESCALON 431 PHONE t.TANK DESCRIPTION(A scaled plot plan with the location of Ne US7 system including buildings and landmarks shall be submitted to the local agency.) TANK ID# Tank#: 6 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑ Yes ❑No 434 TA0506700 TRUSCO If-yes"mmplee oee"mrwrL eos n., DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS Q6 NUMBER OF COMPARTMENTS 437 7/31/1997 5,000 ADDITIONAL DESCRIPTION(For lows aecomy) 438 O.TANK CONTENTS TANK USE 439 PETROLEUM TYPE ® I.MOTOR VEHICLE FUEL ❑ la.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL 440 (IfmarkMomrplec Pcnoken Type) ® Ib.PREMIUMUNLEADED ❑ 3.DIESEL ❑ 6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ Ic MIDGRADE UNLEADED ❑ 3.CHEMICAL PRODUCE ❑ 4.GASOHOL ❑".OTHER COMMON NAME(6om xararmm Matcdala lavmmrypaacl CAS# eom xa�dom Mmeiam lmml ❑4.HAZARDOUS WASTE 441 ( ory page) 442 (Im3 Ua Oil) ❑ 95.UNKNOWN M.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM a3 (Check am nen only) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN M 2.DOUBLE WALL ❑ 4.SINGLE WALL M VAULT [:199.OTHER TANK MATERIAL-primary lank ❑ 1.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 4" (Clackom'ncnoM) ❑ 2.STAINLESS STEEL ® STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary lank ❑ I.BARE STEEL [:13.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 445 (Cnckoacimnaoy) ❑2.STAINLESS STEEL ❑4.STEEL CLAD WNIBERGLASS ❑ S.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑ 99.OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ L RUBBER LINED3.EPDXY LMMC OR COATING ❑ El 5.GLASS LG 95.UNKNOWN 446 DATE INSTALLED ~] (Chmkom imn only) ❑2 ALKYD LINING ❑4 PHENOLIC LINING ®6 UNLINED ❑99.OTHER (Pmlwl manly) OTHER CORROSION ❑ I MANUFACTURING CATHODIC ®;FIBERGLASS REINFORCED PLASTIC ❑ 9 a49 PROTECTION IF APPLICABLE PROTECTION 5 UNKNOWN One DATE INSTALLED (Chcckomiremonly) El IMPRESSED CURRENT E:199 OTHER ❑2 SACRIFICIAL ANODE (For mwl we only) SPILL AND OVERFIILLLr YEAR INSTALLE450 TYPE(meal me only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Chcckall Ihm apply) a1-;I SPILL CONTAINMENT 1,997.00 ❑ I ALARM �FILL TUBE SHUT OFF VAL` 2 DROP TUBE 2 BALL ❑ 4 EXEMPT 3 STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A medFrinn nrdsmmkorim pm®un amn l,eanbmiaed to un local rime,.) IF SINGLE WALL TANK(C all dm apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Chmkemitenmly) ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE TONE ❑ 1 VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 3 CONTINUOUS ATG ❑ 7 GROUNDWATER 912 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING (SIR)BIENNIAL TANK TESTING 990THER [_13 MANUAL MONITORING ❑ V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL] 459 ®Yes ❑No UPCF(12/99 revised)