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FIED PROGRAM CONSOLIDATED FOR Try1r a' 16 PR PR02316M UNDERGROUND STORAGE TANKS - TANK PAGE 1 PAC#: FA0000957 (two pages per tank) Page 2 oF7 TYPE OF ACTIONE] INEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION E]6TEMPORARY SITE CLOSURE (Check oNy itan Daly) ❑ 7 PERMANENTLY CLOSED ON SITE (Sprei(v rear-te bcel uae 3 RENEWAL PERMIT -.1y) (SPaify ream-tm lard we aH ❑ yl STANK REMOVED 430 ❑ _ BUSINESS NAME(S.as FACILITY NAME or DBA-Dams Bmnav A:) FACILITY ID: PR#: I LATHROP GAS&FOOD MART* 3 FA0000957 PR0231600 LOCATION WITHIN SITE(opliaw) 14800 S HWY 99,MANTECA 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 B3# Tank#: 4 a3z TANK MANUFACTURER a33 COMPARTMENTALIZED TANK ❑ Y. []No 434 TA0160004 OWENS CORNING 1f'Ym",eanpknampeeforaebeampaaaent. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS a3e NUMBER OF COMPARTMENTS 437 1/1/1989 12:00:OOAM 10 000 ADDITIONAL DESCRIPTION(Fa].I..my) 439 H.TANK CONTENTS TANK USE a39 PETROLEUM TYPE 440 ® 1.MOTOR VEHICLE FUEL ® Is REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL (Itmelaweacaplaepeat.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(6vm Hanrdms Mare ma I.p6) 4qI CAS#(Bant(m Matcrialslmrnlw page) dal ❑ 4.HAZARDOUS WASTE Nnc[ sUUA Dip ❑ 95.UNKNOWN M.TANK CONSTRUCTION TYPE OF TANK ❑ I.SINGLE WALL ❑3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Cheekeaeitmimly) EXTERIOR MEMBRANE LINER El 95.UNKNOWN 912.DOUBLE WALL ❑4.SINGLE WALL IN VAULT ❑ W.OTHER TANK MATERIAL-primary tank ❑ L BARE STEEL ® FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 444 (Cb karc imm mJy) ❑ 2.STAINLESS STEEL ❑ STEEL CLADW/FIBERGLASS ❑ 8.FRP COMPTBLE W/I00%METHANOL REINFORCED PLASTIC(FRP) ❑99.OTHER TANK MATERIAL-secondary tank ❑ L BARE STEEL 913.FIBERGLASS/PLASTIC ❑ 5.CONCRETE [195.UNKNOWN a5 (CMckrneitemmy) ❑ 2.STAINLESS STEEL ❑4.STEEL CLAD W/FIBERGLASS ❑ 8.FRPCOMPTBLEW/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATEDSTEEL El 99.OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ 1.RUBBER LINED ❑3.EPDXY LINING ❑ 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 447 OR COATING (CnW orc a.myl ❑ 2 ALKYD LINING E]4 PHENOLIC LINING ❑ 6 UNLINED El 99.OTHER (Pm bcel pm mly) OTHER CORROSION ❑ I MANUFACTURING CATHODIC ❑ 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN 448 DATEINSTALLED 449 PROTECTION IF APPLICABLE PROTECTION (Cbeckae temaJ ❑ 4 IMPRESSED CURRENT ❑99 OTHER y) F1 25ACRIFICW.ANODE (Far laalaucNy) SPILL AND OVERFILL YEARBSTALLE00 TYPH(loealpeedy) 451 OVERFILL PROTECTION EQUIPMENT'YEAR INSTALLED 452 (Chakalllhvappy) ® I SPILL CONTAINMENT 2,003.00 OPW ® ?ALARM 2,003.00 ® 3 FILL TUBE SHUT OFF VAL,2,003.00 x❑ 2 DROP TUBE 2,003.00 OPW ❑ 2 BALL ❑ 4 EXEMPT ❑X 3STRICER PLATE 2,003.00 W/MAGNET FLOAT IV.TANK LEAK DETECTION(A aa.9 hembeilnedro Ne leeal agny.) IF SINGLE WALL TANK(Ch all out appy) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ I VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Ch Aaaaai many) ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑ 6VADOSE ZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 3CONTINUOUS ATG ❑ ]GROUNDWATER ®2 CONTINUOUS INTERSTITIU.MONITORING ❑ 4 STATISTICAL INVENTORY RECONCILIATION ❑ STANK TESTING ❑3 MANUAL MONITORING (SIR)BIENNIAL TANK TESTING F1 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)