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UNIFIED PROGRAM CONSOLIDATED I M UNDERGROUND STORAGE TANK' OPERATING PERMIT APPLICATION-TANK INFORMA one form per UST) TYPE OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections I,II,III,IV,and IX below) a3o ❑ 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ® 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST REMOVAL DATE UST PERMANENTLY CLOSED: 's I DATE EXISTING UST DISCOVERED: 43% L FACILITY INFORMATION FACILITY ID#(Agency Use Only) BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) a 3 VANCO TRUCK&AUTO PLAZA BUSINESS SITE ADDRESS 103 CITY 104 1033 W. CHARTER WAY STOCKTON CA 95206 II.TANK DESCRIPTION TANK ID# DIESEL SOUTH 432 TANK MANUFACTURER 433 TANK CONFIOuEATION: THIS TANK is 43d [� Ownes Coming FiberGlBs ®1.A STAND-ALONE TANK Corp ❑ ONE INA Completeonpale for n c npeemmt m the wd. AVUIS 49 Y STEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437 MAY 2003 12 o S 16 S h 20000 GALLONS TIL TANK USE AND CONTENTS TANK USE ® 1a MOTOR VEHICLE FUELING ❑ 1b.MARINA FUELING ❑ lc.AVIATION FUELING d39 ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(m I do Ueed Oil) ❑ 5.EMERGENCY GENERATOR FUEL IHSC§25281.5(c)l ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 439a CONTENTS PETROLEUM: ❑ Ie.REGULAR UNLEADED ❑ In MDGRADE UNLEADED ❑ 1b.PREMIUM UNLEADED 440 ® 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ S.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM 440° NON-PETROLEUM:0 7.USED OIL 10.ETHANOL ❑ II.OTHER NON-PETROLEUM(Specify): 4106 W. TANK CONSTRUCTION TYPE OF TANK 1.SINGLE WALL tig 2.DOUBLE WALL 95.UNKNOWN 443 PRIMARY CONTAINMENT U 1.STEEL R9 3.FIBERGLASS 6.INTERNAL BLADDER 444 ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER IS T city): 444° SECONDARY CONTAINMENT 1.STEEL 3.FIBERGLASS 6.EXTERIOR MEMBRANE LINER T JACKETED 445 90.NONE ❑ 95.UNKNOWN ❑99.OTTER(Specify): 445° OVERFILL PREVENTION 1.AUD1BLE&VISUAL ALARMS Pk2.BALLFLOAT U 3.FILL T U13E SHUT-OFF VALVE 452. 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT/WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION 0 1.SINGLE-WALLED ®2.DOUBLE-WALLED ❑99.OTHER 460 SYSTEMTYPE H L PRESSURE ❑ 2.GRAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION 123 CCR§2636(a)(3I 458 PRIMARY CONTAINMENT 1.STEEL ER 4.FIBERGLASS 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464 ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464a SECONDARY CONTAINMENT 0 1.STEEL 0 4.FIBERGLASS C3 S.FLEXIBLE ❑ 10.RIGID PLASTIC 46lb ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Speafy): 464c PIPINGINRBINE CONTAINMENT SUMP TYPE IN 1.SINGLE WALL 2.DOUBLE WALL ❑ 90.NONE 4614 VL VENT,VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT U 1,STEEL 0 4.FIBERGLASS Ll 10.RIGIDPLASTIC Lj 90.NONE 99.OTHER(Specify) 464e 464e1 VENT SECONDARY CONTAINMENT 0 L s= M 4.FIBERGLASS 10.RIGID PLASTIC 90.NONE0 99.OTHER(Specify) 464f 454(1 VR PRIMARY CONTAINMENT 0 1.STEEL W 4.FIBERGLASS 10.RIGID PLASTIC 90.NONE L1 99.OTHER(Specify) 4648 - 464'l VR SECONDARY CONTAINMENT 0 1.STERL A 4.FIBERGLASS 0 10.RIGID PLASTIC M 90.NONE U 99.OTHER(Specify) 46 MW VENT PIPING TRANSITION SUMP TYPE 0 1,SINGLE WALL 2.DOUBLE WALL tff 90.NONE 464i. RISER PRIMARY CONTAINMENT 1.STEEL W 4.FIBERGLASS 0 10.RIGID PLASTIC U 90.NONE U 99.OTHER(Specify) 464j 4641 RISER SECONDARY CONTAINMENT 1.STEEL IM 4 FIBERGLASS Ll 10.RIGID PLASTIC IQ 90.NONE Ll 99.OTHER(Specify) 464k M&I FILL COMPONENTS INSTALLED 1.SPILL BUCKET 3.STRIKER PLATEIBOTTOMPROTECTOR 4.CONTAINMENT SUMP 451. VII. UNDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE1.SINGLE 4N Z DOUBLE WALL ❑ 3.NO DISPENSERS ❑ 90.NO WALL 469° CONSTRUCTION MATERIAL 1.STEEL 4.FIBERGLASS JR 10.RIGID PLASTIC 99.OTHER(Specify) 4696c VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4 IMPRESSED CURRENT ❑ 6.ISOLATION as•.,.,., 44a. DL APPLICANT SIGNATURE y� CERTIFICATION: I certify that this UST system is compatible with the hazardous substance stored and that the information provided he accarwfe, and in toll co h legal regu1jrennet. APPLICANT SIGNATURE DATE 6/9/2009 APPLICANT NAME(print) MiRLYOuVarai APPLICANT TITLE Owner 4R