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r� +PIED PROGRAM CONSOLIDATED FOF_ TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 1 \AVox (two pagespe Ank) page-of ❑ 7 PERMANENTLY CLOSED ON SITE TYPE OF ACTION ❑1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT N 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSUREm 3 RENEWAL PERMIT (Specify reason-tor local use only) ( P eu 430 -� 8 TANK REMOVED (Check me iteonly) S reason-forlocal use only) ❑ 1 ❑ fY FACILITY ID: b BUSINESS NAME(Same as FACILITY NAME or OBA-Doing Business As) 3 431 7-Eleven#14117 LOCATION WITHIN SITE(Optional) 2725 Count Club Dr., Stockton, CA I.TANK DESCRIPTION (A scaledplotplan wim im IoeatloR.of the agent stem incl 43°g COMPARTMENTALIZED TANK uildingS and landmarKS'hall be 5❑Yese® No local434 TANK ID# 432 TANK MANUFACTURER 3 If"Yes",complete one page for each compartment. 437 Total Containment a3s NUMBER OF COMPARTMENTS ATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 4/1998 10,000 438 ADDITIONAL DESCRIPTION(Forlocal use only) II.TANK CONTENTS 440 TANKUSE 439 PETROLEUM TYPE [35. JET FUEL ®1. MOTOR VEHICLE FUEL N 1a. REGULAR UNLEADED ❑2. LEADED ❑e AVIATION FUEL (If marked complete Petroleum Type) [I 1b. PREMIUM UNLEADED 03. DIESEL 99 OTHER_ 442 ❑2. NON-FUEL PETROLEUM ❑ic. MIDGRADE UNLEADED ❑4. GASOHOL 441 CAS#(from Hazardous Materials Inventory page) ❑3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page)) ❑4. HAZARDOUS WASTE Gasoline (includes Used Oil) ❑ 95.UNKNOWN III, TANK CONSTRUCTION 443 TYPE OF TANK ❑ 1. SINGLE WALL El 3,SINGLE WALL WITH ❑5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM EXTERIOR MEMBRANE LINER ❑95. UNKNOWN (Check one item only) 2. DOUBLE WALL EI 4. SIGNLE WALL IN VAULT ❑99. OTHER_ 444 ® ❑95. UNKNOWN TANK MATERIAL-primary tank N 1. BARE STEEL ❑3. FIBERGLASS/PLASTIC ❑ 5. CONCRETE (Check one item only) [12. STAINLESS STEEL ❑4. STEEL CLAD W/FIBERGLASS ❑8. FRP OIBLE W/ ❑99.OTHER 700%METHANOL REINFORCED PLASTIC(FRP) 95. UNKNOWN 445 STIC TANK MATERIAL-s¢condatytank O 5. CONCRETE 2. STAINLESS STEEL❑❑4.3. IBERGLASS I STEEL CLAD WWF BERGLASS❑❑8. FRP COMPATIBLE N 99.OTHER (Check one item only) REINFORCED PLASTIC(FRP) W/100%METHANOL ❑5. CONCRETE ❑10.COATED STEEL DATE INSTALLED 447 TANK INTERIOR LINING ❑1.RUBBER LINED ❑3.EPDXY LINING ❑5.GLASS LINING ❑95.UNKNOWN 446 OR COATING ❑2 ALKYD LINING ❑4 PHENOLIC LINING ®6 UNLINED ❑ 99 OTHER (For local use only) 448 DATE (Check one item only) INSTALLED 448 95 UNKNOWN OTHER CORROSION ❑1 MANUFACTURED CATHODIC❑3 FIBERGLASS REINFORCED PLASTIC ❑9 OTHER PROTECTION IF APPLICABLE PROTECTION [14 IM CURRENT ❑ (For local use only) ❑ 452 (Check one item only) [12 SACRIFICIAL ANODE SPILL AND OVERFILL YEAR INSTALLED 450 TYPE(local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED (Check all ®1 SPILL CONTAINMENT 1998 ❑1 ALARM N 3 FILL TUBE SHUT OFF VALVE that apply) ❑2 BALL FLOAT Cl 4 EXEMPT ®2 DROP TUBE 1998 N 3 STRIKER PLATE 1998 IV.TANK LEAK DETECTION(A description of the monitoring program.shell 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) e VADOSE ZONE N 2 CONTINUOUS INTERSTITIAL MONITORING ❑ 3 MANUAL MONITORING ❑3 CONTINUOUS ATG ❑7 GROUNDWATER ❑ ❑4 STATISTICAL INVENTORY RECONCILIATION ❑8 TANK TESTING +(SIR) BIENNIAL TANK TESTING [I99OTHER __ IV.TANK CLOSURE INFORMATION I PERMANENT.CLOSUREaM PLACE 457 455 ESTIMATED QUANTITY OF SUBSTANCE TANK FILLED WITH INERT MATERIAL? ESTIMATED DATE LAST USED(YR/MO/DAY) REMAINING E]Yes [INo gallons Formerly SW C13 FOCE3 UPCF (1199 revised) Formerly SWRCB Forrnnk�_3/