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IED PROGRAM CONSOLIDATED FORM (� : TA0508266 v PR#: PR0231509 UNDERGROUND STORAGE TANKS - TANK PA `�N AC#: FA0003809 (two pages per tank) TYPE OF ACTION ❑ 1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE Page 4 of 7 (Chwk only nen only) ❑ 7 PERMANENTLY CLOSED ON SITE (SPemytmam Farlaah.only) ($pttiCymson lomiuttonty) 3 RENEWAL PERMIT ❑ 8 TANK REMOVED 430 BUSINESS NAME(Smtcu FACILDYNAMB.DBA-Doing Bwinaa As) FACILITY ID: PRA: I A G SPANOS AVIATION DEPT FA0003809 PR0231509 LOCATION WITHIN SITE(opdmep 4800 S AIRPORT WAY,STOCKTON 431 PHONE I.TANK DESCRIPTION(A scaled plot plan With the location of the UST system including buildings and landmarks shall be subrnitled to the local agency.) TANK ID# Tank#: 4 432 TANK MANUFACTURER 1- 433 COMPARTMENTALIZED TANK El Yes No 434 TA0508266 F1u1d Cora AS�MF/1�' IF"Yat•,c Ictc anepagc rot eaatwanpamnml. DATE INSTALLED((YYEAR/M ) 4J5 TANK CAPACTTY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 20 000 ADDITIONAL DESCRB6TI0 (Fwlm ltaeowy) 938 H.TANK CONTENTS TANK USE 639 PETROLEUM TYPE 440 ❑ 1.MOTOR VEHICLE FUEL ❑ In.REGULAR UNLEADED ❑ 2.LEADED ® $JET FUEL pf matkd wmplec pcwlcumtypc) ❑ Ib.PREMIUM UNLEADED [:13.DIESEL ❑ 6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ Ic MIDGRADE UNLEADED ❑ 4.GASOHOL [-199.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(fmm H.- w Materials Immtorypage) 441 CAS#(f Raaatdom Maleiab Immlory page) 442 ❑ 4.HAZARDOUS WASTE (Include Uacd oil) 95.UNKNOWN IH.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Chock one nvn only) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN ® 2.DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT ❑ 99.OTHER TANK MATERIAL-Primary tank ❑ 1.BARE STEEL ® FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 444 (Chmk ms iuen only) ❑ 2.STAINLESS STEEL ❑ STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ L BARE STEEL 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (C komitmmy) ❑ 2.STAINLESSSTEEL 4.STEEL CLAD W/FIHERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑ 99.OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ 1.RUBBER LINED ❑3.EPDXY LINING 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 447 OR COATING (Cluck oat item only) ❑ 2 ALKYD LINING ❑4 PHENOLIC LINING ❑ 6 UNLINED ❑99.OTHER (For local use Dory) OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC ®3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ((Ilued one immony) ❑4 IMPRESSED CURRENT ❑99 OTHER ❑ 25ACRIFICW.ANODE (Forlaoluu Dory) SPILL AND OVERFILL YEAR INSTALLE450 TYPE(lo4almcoNy) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all t6as appy) ❑ 1 SPILL CONTAINMENT ❑ 1 ALARM ❑ 3 FILL TUBE SHUT OFF VAL` ❑ 2 DROP TUBE ❑ 2 BALL ❑ 4 EXEMPT ❑ 3STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A deagtioo ofd,, tarluapmigam shJl M sandued w err local agency.) IF SINGLE WALL TANK(Cmck all that apply) 453 IF DOABLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (C me nem only) ❑ 2AUTOMATIC TANK GAUGING(ATG) ❑ 6VADOSEZONE ❑ 1 VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 3CONTIN000S ATG ❑ 7GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING ❑3 MANUAL MONITORING (SIR)BIENNIAL TANK TESTING ❑ 99 OTHER 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? 457 -HI`2� 0.00 gallons ❑Yes ❑ No UPCF(12/99 revised)