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1r FIED PROGRAM CONSOLIDATED FORM �j TANK: TA0102806 �t IL�V 1 PR#: PRO231028 UNDERGROUND STORAGE TANKS - TANK PAGE 1 r FAC#: FAank) (two pages per tarok) Page 4 of 5 TYPE OF ACTION (Clack�n=�,) ❑ I NEW SITE PERMIT ❑4 AMENDED PERMIT XCHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE ❑ 7 PERMANENTLY CLOSED ON SITE ❑ 3 RENEWAL PERMIT ..•u - ❑8 TANK REMOVED 330 BUSINESS NAME(Same as FACILITY NAME or DDA-Doing 9usiness As) FACILITY ID: PR#: RIVER POINT LANDING MARINA-RESORT* FA000381] 7 PR0231028 LOCATION WITHIN SITE(optia i) 4950 BUCKLEY COVE WAY,STOCKTON 4=1 PHONE 1.TANK DESCRIPTION(A scaled plat plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANK ID# Tank#: 6432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK [jYes E]No 474 TA0102806 "►>< If'Ycs",mmplere one Pa8e for eaeh c Panaurn. DATE INSTALLED(YEAR/MO) 411 TANK CAPACITY IN GALLONS 476 NUMBER OF COMPARTMENTS 437 3/1/1989 12:00:OOAM 5,000 ADDITIONAL DESCRIPTION(For Ioca1 use onh) 438 IL TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 I.MOTOR VEHICLE FUEL ❑ 1. REGULAR UNLEADED ❑ 2.LEADED '❑ 5.JET FUEL pfmarked c pine Petrotcam T.pe) ❑ Ib.PREMIUM UNLEADED 3.DIESEL ❑ 6.AVIATION FUEL ❑2.NON-FUEL PETROLEUM © tc.MIDGRADE UNLEADED ❑ 4.GASOHOL 99.OTHER ❑3.CHEMICAL PRODUCT COMMON NAME(f Hazardous Materials Imentory page) 441 CAS#(from Hazordous Materials 1ntay page) 44, ❑4,HAZARDOUS WASTE (lneladcs Used Oil) ❑95.UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK ❑ ].SINGLE WALL ❑3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Chxk one aem unh) EXTERIOR MEMBRANE LINER ❑ 95 UNKNOWN ® 2.DOUBLE WALL ❑4.SINGLE WALL IN VAULT ❑ 99.OTHER TANK MATERIAL-pnmary tank 1.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 444 (Chwk one hem anh) ❑ 2.STAINLESS STEEL ❑ STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/I00°/u METHANOL REINFORCED PLASTIC(FRP) ❑ 99,OTHER. TANK MATERIAL-secondary tank ❑ 1.BARE STEEL ❑ 3.FIBERGLASS I PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (Check-item onW) ❑ 2.STAINLESS STEEL 4.STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/lW/a 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 4a7 OR COATING (Chink ran:dera only) ❑ 2 ALKYD LINING ❑ 4 PHENOLIC LINING ❑ 6 UNLINED E]99.OTHER (For local use ante) OTHER CORROSION ❑ I MANUFACTURING CATHODIC ❑3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION (Chale otre item only) ❑ 4 IMPRESSED CURRENT E]99 OTHER ❑ 2 SACRIFICIAL ANODE (For local use onh) SPILL AND OVERFILL YEAR INSTALLE450 TYPE(local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all that apply) ® I SPILL CONTAINMENT 1,996.00 5 GAL l ❑ I ALARM ff] 3 FILL TUBE SHUT OFF VAL' ❑x 2 DROP TUBE 1,996.00 2 BALI, 1,996.00 ❑ 4 EXEMPT ❑ 3 STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A desaiptimr of the monitoring program shall be suhm ttcd w the Imal agKn ) IF SINGLE WALL TANK(Chat:all that apply) 343 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ I VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (.Chale one item unh) E] 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 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 ❑Yes ❑No UPCF(12/99 revised)