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* �IIFIED PROGRAM CONSOLIDATED FOP TANKS i UNDERGROUND STORAGE TANKS - TANK PAGE 1 (two pages per tank) Page-of CLOSURE TYPE OF ACTION ❑1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ® 5 CHANGE OF INFORMATION ❑O TEMPORARY SITE TLY CLOSED ON SITE (Check one item only) 430 ❑ 3 RENEWAL PERMIT (Specifyreason-for local use only) (Specifyreason-for local use only) ❑ 8 TANK REMOVED 1 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As 3 FACILITY ID: 7-Eleven#14117 431 LOCATION WITHIN SITE(Optional) 2725 u Cont Club Dr., Stockton, CA I.TANKAESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local a anti . TANK ID# 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yes ® No 434 If-Yes".complete one page for each compartment. Total Containment DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 4ss NUMBER OF COMPARTMENTS 497 4/1998 10,000 438 ADDITIONAL DESCRIPTION(Forlocal use only) -11.TANK CONTENTS 44o TANK USE 438 PETROLEUM TYPE ®1. MOTOR VEHICLE FUEL ®Ia. REGULAR UNLEADED [12. LEADED []5, JET FUEL (If marked complete Petroleum Type) ❑ib. PREMIUM UNLEADED ❑3. DIESEL ❑6. AVIATION FUEL [12. NON-FUEL PETROLEUM [31c. MIDGRADE UNLEADED [14. GASOHOL ❑99.OTHER_ 442 ❑3. CHEMICAL PRODUCT COMMON NAME (from Haiartlous Materials Inventory page) 441 CAS#(from Hadundou5 Materials Inventory page) ❑4. HAZARDOUS WASTE Gasoline (Includes Used Oil) ❑95.UNKNOWN III, TANK CONSTRUCTION DDER SYSTEM 443 TYPE OF TANK ❑1. SGLE WALL ❑3.SINGLE WALL W ITH ❑5. SINGLE WALL W ITH INTERNAL BLA IN (Check one item only) EXTERIOR MEMBRANE LINER ❑95. UNKNOWN ®2. DOUBLE WALL ❑4. SIGNLE WALL IN VAULT ❑99. OTHER_ 444 TANK MATERIAL-pnmary tank 1. BARE STEEL ❑3. FIBERGLASS/PLASTIC ❑5. CONCRETE ❑95. UNKNOWN (Check one item only) ❑2. STAINLESS STEEL [14. STEEL CLAD W/FIBERGLASS [18. FRP COMPATIBLE W/ [199.OTHER REINFORCED PLASTIC(FRP) 100°/6 METHANOL TANK MATERIAL-secondaryknk Ell. BARE STEEL ❑3. FIBERGLASS/PLASTIC ❑5. CONCRETE C-]-65. UNKNOWN 445 (Check one item only) ❑2. STAINLESS STEEL 0 4.STEEL CLAD W/FIBERGLASS ❑S. FRP COMPATIBLE ❑99.OTHER REINFORCED PLASTIC(FRP) W1100%METHANOL [15. CONCRETE [110.COATED STEEL TANK INTERIOR LINING ❑1.RUBBER LINED ❑3.EPDXY LINING ❑5.GLASS LININGEE EE LED447OR COATING ❑2 ALKYD LINING ❑4 PHENOLIC LINING ®8UNLINED y)(Check ane Ilam only) LED 449OTHER CORROSION ❑1 MANUFACTURED CATHODIC❑3 FIBERGLASS REINFORCED PLASTIPROTECTION IF APPLICABLE PROTECTION ❑4IMPRESSED CURRENT nly) (Check one item only) ❑2 SACRIFICIAL ANODE 452 SPILL AND OVERFILL YEAR INSTALLED 450 TYPE local use only) 451 OVERFILL PROTECTION EOUIPMENT:YEAR INSTALLED (Check all M 1 SPILL CONTAINMENT 1998 ❑1 ALARM ®3 FILL TUBE SHUT OFF VALVE that appy) ®2 DROP TUBE 1998 ❑2 BALL FLOAT ❑4 EXEMPT ®3 STRIKER PLATE 1998 _ IV.TANK LEAK DETECTION(A description M the monitoring program shall be submitted to the local agency.) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 IF SINGLE WALL TANK(Check all that apply) (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 ❑B TANK TESTING +(SIR) BIENNIAL TANK TESTING ❑99 OTHER IV.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE 457 455 ESTIMATED QUANTITY OF SUBSTANCE 45s TANK FILLED WITH INERT MATERIAL? ESTIMATED DATE LAST USED(VR/MO/DAY) REMAINING gallons ❑Yes ❑ No UPCF(1/99 revised) Formerly SV/RCB Form B