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NIFIED PROGRAM CONSOLIDATED FORN TANK: TAOSN223 %pd -� �.� PR#: PRO506221 UNDERGROUND STORAGE TANKS -TANK PAG FAC#: FA0007297 410 (I!`/--' (two pages per tank) Pagc 4 of7 TYPE OF ACTION ❑ INEW SITE PERMIT ❑ 4AMENDED PFRMII X5 CH\N(;L OF INFORMA I ION ❑ 6 TEMPORARY SITE CLOSURE (L7rk odY igen mdy) ❑ )PERMANENTLY CLOSED ONSITE (SP-.fYrmam-fmbdme-Iy) (sI =M-f Ix Wcody) E] 8TAW REMOVED UB ❑ 3RENEWAL PERMIT BUSINESS NAME(Saemm FACB.IIYNAMEm DBA.Doisy Buenas As) 31 FACILITY ID: PR ft: I FLAG CITY ARCO/SUBWAY FA0007287 1:1 1, LOCATION WITHIN SITE(Dptiam) 14931 N FLAG CITY BLVD,LODI 431 PHONE L TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings and landomrks shall be submitted to the local agency.) TANK ID# Tank#: 2 432 1 TLYFACpl1BEBN 433 COMPARTMENTALIZED TANK ,dyes ❑No ax TA0506223 [�(Jr Irre.�nPlaro�eP�e��uoanwn��v DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 4/1/1997 12:00:OOAM 10 000 ADDITIONAL DESCRIPTION(Fm bd meomy) 438 IL TANK CONTENTS TANK USE 4J9 PETROLEUM TYPE 44B ® I.MOTOR VEHICLE FUEL $la.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL nfma,ke Plac Pmmlwm T,,n ❑ Ib.PREMIUMUNLEADED ❑ 3.DIESEL ❑6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM Ic,MIDGRADE UNLEADED ❑ 4.GASOHOL ❑ 99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(fmm�Mmai4ls m.mmypege) 441 CAS#(ham Hmmdaec Mmmiale brvmky page) 442 ❑4.HAZARDOUS WASTE (boludm UcdaO ❑ 95.UNKNOWN IH.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM MJ (CbNrm¢Itan odY) 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 4w (Clch o ]l mly) ❑ 2.STAINLESS STEEL ❑ STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ W.OTHER TANK MATERIAL-secondary tank ❑ 1.BARE STEELJ��3 FIBERGLASS/PLASTIC F] 5.CONCRETE ❑95.UNKNOWN 445 (Ch mn iwn Dory) ❑2.STAINLESS STEEL IJ 4.STEEL CLAD W/FIBERGLASS ❑ S.FRP COMPTIBLE W/100%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 446 DATE INSTALLED u7 OR COATING (O1 cac itano ly) ❑2 ALKYD LINING ❑4 PHENOLIC LINING ®6 UNLINED ❑99.OTHER (Far bol memb) OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC ® 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN 448 DATE INSTALLED a49 PROTECTION IF APPLICABLE PROTECTION ICIu -iranoalyl ❑41MERESSED CURRENT El99OTHER ❑ 25ACRIFICIAL ANODE (Fo 1pol me ob) SPILL AND OVERFILL YEAR INSTALLE459 T PE pod m<mb) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Chdcdl dut apply)gyp I SPILL CONTAINMENT C119T40 /W ` ❑ 1 ALARM , �S FILL TUBE SHUT OFF VALS 2 DROP TUBE ZcYff ❑ 2 BALL ❑4 EXEMPT ❑ 3 STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A m Pnoaonbe moaimmn Pmpem scall bc.onm umdto the Iouae y.) IF SINGLE WALL TAW(Chrkall out apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ I VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Oh m4 itan m7) ❑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 ❑ 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 1 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 ❑Yes ❑ No UPCF(12/99 revised)