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IFIED PROGRAM CONSOLIDATED FORM ANK: TA0508267 PR#: PR0231509 UNDERGROUND STORAGE TANKS -TANK PA FAC#: FA0003809 two pages per tank) TYPE OF ACTION El NEW SITE PERMIT 4AMENDED PERMIT Pagerk) (Clink only item only) ❑ ❑ SC14ANGE OF INFORMATION ❑6 TEMPORARY SITE CLOSURE ❑ 7 PERMANENTLY CLOSED ON SITE 3 RENEWAL PERMIT ❑ STANK REMOVED 430 BUSINESS NAMES.as FACILITY NAME or DBA-Donna Bo;noa Ae) FACILITY ID: PR#: 1 A G SPANOS AVIATION DEPT 3 FA0003809 PR0231509 LOCATION WITHIN SITE(0ptiorep 48pp 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 subrmtted to the local agency.) TANK ID# Tank#: 5 432 TANK MAN1UFACTURER 433 COMPARTMENTALIZED TANK ��....aa�r TA0508267 l U f O CON)WA �f� ❑Yes pp No 43a If"YM wepOFCOMP OMfar RT wmpaTs DATE INSTALLED(YE O) �^ 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 12 000 ADDTCIONAL DESCRY ION(Fmloe.l uuonly) 43s D.TANK CONTENTS TANK USE 439 PETROLEUM TYPE ❑ I.MOTOR VEHICLE FUEL ❑ la.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL d40 (IfmaakdwnPlnc Penolcmn Type) ❑ Ib.PREMIUM UNLEADED ❑ 3.DIESEL ® 6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ Ic.MIDGRADE UNLEADED ❑4.GASOHOL ❑ 99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(6om Hamdom Matvials Invenm ❑4.HAZARDOUS WASTE ryP°8") 491 CAS#f6om Haad°o Matciatalmrnt°ry page)'. 42 (I JWo Uad OiO ❑95.UNKNOWN DI.TANK CONSTRUCTION TYPE OF=TANKE1 .SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 one iEXTERIOR MEMBRANE LINER 95.UNKNOWN .DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT ❑ 99.OTHER TANK MATERIAL-primary tank ❑ I. ARE STEEL ® FIBERGLASS/PLASTIC 5.CONCRETE ❑ ❑95.UNKNOWN a44 (Checkone nem only) ❑ 2.STAINLESS STEEL ❑ STEEL CLAD W/FBERGLASS ❑ S.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary rank ❑ 1.BAKE STEEL 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN a45 (Check on itrn only) ❑ 2.STAINLESS STEEL [ 4.STEEL CLAD W/FIBERGLASS ❑ S.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑ 99.OTHER ❑5.CONCRETE E- F EEEEEEEEN 1.RUB BER LINED ❑ 3.EPDXY LINING 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 2ALKYO LINING ❑ 4PHENOLIC LINING ❑ 6UNLINED ❑ 99.OTHER 1 MANUACTURING CATHODICROTECTION 093 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN Ms DATEINSTALLED M9 SACRIFICIAL ANODE ❑4 IMPRESSED CURRENT ❑99 OTHER (Fm l"cala9e"ny) D OVERFILLLLj YEAR WSTALLE450 TYPEOocs-e0*) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Ch all that apply) I SPILL CONTAINMENT 2 DROP TUBE Ll 1 ALARM 3 FILL TUBE SHUT OFF VAL' �3 STRIKER PLATE E] 2 BALL 4 EXEMPT FLOAT IV.TANK LEAKDETECTION(Ad cripeoaorwenonowina mosmm.61,he a nrdtd to one local''y.) IF SINGLE WALL TANK(Checkall the appy) 453 D DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Chink 0m noamnly) ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑ 6 VADOSE ZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑3 CONTINUOUS ATG ❑7 GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ g TANK TESTING (SIR)BIENNIAL TANK TESTING ❑3 MANUAL MONITORING ❑ 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 t yy� 0.00 gallons ❑Yes ❑ No UPCF(12/99 revised)