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IED PROGRAM CONSOLIDATED FORM TANK: TA0506494 PAN: PRO231057 UNDERGROUND STORAGE TANKS - TANK PAGE 1 FAC M FAOD03720 (two pages per tank) TYPE OF ACTIONEl I ❑ ❑ Page 4 of 7 (Chxl:wl.nem mh) NEW SITE PERMIT ❑ 4AMENDED PERMIT SCHANGE OF INFORMATION 6TEMPORARY SITE CLOSURE E] 7 PERMANENTLY CLOSED ON SITE F13RENEWAL PERMIT (SpaJy rcasw fm tical use ooh) °"q`P` " ❑8TANK REMOVED 430 BUSINESS NAME(S.me u FACILITY NAME a DBA-Doing B...nass As) FACILITY ID: PR#: I CHEVRON#92033* FA0003720 PR0231057 LOCATION WITHIN SITE(Opum.n 508 W CHARTER WAY,STOCKTON 431 PHONE 1.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANK ID# Tank#: 9 432 TANK MANUFACTURER 443 COMPARTMENTALIZED TANK ❑Yes [-]No 434 TA0506494 PLASTEEL If•Yar,mmpinoono page for .chmmpmsm.m DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 2/10/1997 12:0O:OOAM 12,000 ADDITIONAL DESCRIPTION(Fos Ixal,.seoan) 439 It.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ® I.MOTOR VEHICLE FUEL ❑ In.REGULAR UNLEADED ❑ 2.LEADED ❑5.JET FUEL (Ifma v%nploc Pcu*)e T.pe) ❑ Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ® Ica MIDGRADE UNLEADED ❑ 4.GASOHOL ❑ 99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(axxmMmals in-un pgo) 441 CAS#(f Halms Mmals msmmp page)) aa2 ❑ 4.HAZARDOUS WASTE (Ixladm Us Oil) ❑ 95.UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK ❑ L SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Chxk aneimn on h) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN ® 2.DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT ❑ 99.OTHER TANK MATERIAL-Primary tank ❑ I.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN m4 (Chx cwilanpnh) ❑2.STAINLESS STEEL ® STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100°/METHANOL REINFORCED PLASTIC(FRP) ❑99.OTHER TANK MATERIAL-secondary tank ❑ LEASE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (Chxkamimmaoh) ❑ 2.STAINLESS STEEL ❑ 4.STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE WAW/e METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑99.OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ L RUBBER LINED ❑ 3.EPDXY LINING ❑ 5.GLASS LINING ❑95.UNKNOWN 44e DATE INSTALLED 447 OR COATING (Check mm imn mh) ❑ 2ALKYD LINING ❑4PHENOLIC LINING ❑ 6UNLINED ❑99.OTHER (For tical useanly) OTHERCORROSION ❑ 1 MANUFACTURING CATHODIC ® 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN 444 DATE INSTALLED a9 PROTECTION IF APPLICABLE PROTECTION (Chxk on lmm mlr) 2SACRIFICW.ANODE ❑ 4 IMPRESSED CURRENT E] "OTHER ❑ (Fm lxel a<anh) SPILL AND OVERFILL YEAR INSTALLE450 TYPE(bw.Wl) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Chxkalldm.pp15) ❑ I SPILL CONTAINMENT 1,997.00 ❑ IALARM ❑ 3 FILL TUBE SHUTOFF VAL` ❑ 2 DROP TUBE ❑ 2 BALL ❑ 4 EXEMPT ❑ 3 STRIKER PLATE FLOAT rV.TANK LEAK DETECTION(A 1wnpdan orae-tonng program shall be sa6mwaa u uK Ix.Lgrnw.) IF SINGLE WALL TANK(Chxk A N.I.pph) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ I VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Chock monvn anh) ❑ 2AUTOMATIC TANK GAUGING(ATG) ❑ 6VADOSE ZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 3CONTIN000S ATG ❑ 7GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ STANK 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 1 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 1 TANK FILLED WITH INERT MATERIAL' 457 ❑Yea ❑ No UPCF(12/99 revised)