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LIED PROGRAM CONSOLIDATED FORM • ,, f, a AxK; esLsc�s �y- f� UNDERGROUND STORAGE TANKS - TANK PAGE 1 FAPR#: RO C#: EABB19452 (two pages per tank) TYPEnhuenoON ❑ INEW SITE PERMIT 4AMENDED PERMIT Page2of5 (ChwkmFACTIly) ❑ 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE El 3RENEWAL PERMIT l (Sp-f -sun-fm Ircu1 use oam SP« ms%on ❑ 7 PERMANENTLY CLOSED ON SITE N -sur laatusc omsJ ❑8TANK REMOVED 430 BUSINESS NAME(S..FACILITY NAME w DBA-D6111:11 l�eAsl T ID P I RAPID SERVICE CENTE ° ° PRS LOCATION WITHIN SITE(OpdmaO 3550 S HWY 99,STOCKTON 431 PHONE L TANK DESCRIPTION(A scat plot plan with the location of the U57 system including buildings and landmarks shall be submitted 10 the local agency.) TANK ID# Tank#: 1 / N TANK MANUFACTURER 43J COMPARTMENTALIZED TANK II MODERN WELDING CO INC vYe.•,w�npkamep.ger«�npaop.n,�,m1 ®Yes E]No 434. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY RJ GALLONS 436 NUMBER OF COMPARTMENTS 437 9 000 ADDITIONAL DESCRIPTION F.lural urcmty) - 439 IL TANK CONTENTS TANK USE 439 PETROLEUM TYPE ® 1.MOTOR VEHICLE FUEL ® 1 a.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL a10 Rfnwk .pMcP.kva T)Pe) ❑ Ib.PREMIUMUNLEADED3.DIESEL ❑ ❑b.AVIATION FUEL [:12 NON-FUEL PETROLEUM ❑ Ic.MIDGRADE UNLEADED ❑ 4.GASOHOL [:199.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME from xiu�om mmaiels m.m ( bry page) 441 CA$#(fmm Hawdmu Meuni4ls lnvenbry page) ❑4.HAZARDOUS WASTE 442 (Im1Wcs Used Din ❑ 95.UNKNOWN ID.TANK CONSTRUCTION TYPE OF TANK ❑ I.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Chxkonciummh) EXTERIOR MEMBRANE LINER El 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 44 (Chxk me ilial ❑ 2.STAINLESS STEEL ❑ STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100°.METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ 1.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (Chak arc i.eal59 ❑ 2.STAINLESS STEEL ® 4.STEEL CLAD W/FIBERGLASS ❑ 6.FRP COMPTIBLE W/100°.METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑ 99.OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ 1.RUBBER LINED 3.EPDXY LINING 447 OR COATING ❑ ❑ 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED (Clwck o^e acnn mb) ❑2 ALKYD LINING ❑4 PHENOLIC LINING ®6 UNLINED ❑99,OTHER (Fm localuse mb) OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC 449 PROTECTION IF APPLICABLE PROTECTION M 3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 4 s DATE INSTALLED (Chakanehnm anh) 2 SACRIFICIAL ANODE ❑4 IMPRESSED CURRENT ❑ 99 OTHER ❑ (Fm Imd useaNr) SPILL AND OVERFILL YEAR•INSTALLE450 TYPE O«ol asnmh9 451 OVERFILL PROTECTION EQUIPMENT'.YEAR INSTALLED 452 (Checkallnhaeppty) ® I SPILL CONTAINMENT 1,995.00 A1004-010 ❑ 1ALARM ® 3FILL TUBE SHUT OFF VAL` 1,995.00 Q 2DROP TUBE 1,995.00 A20-10/Al 100-1 ❑ 2BALL ❑4EXEMPT Q 35TRI,ERPLATE 1,995.00 STEEL PLATE FLOAT W.TANK LEAK DETECTION(A@ PumnfWeshoo he.nb-nod u We wem ngmg.7 IF SINGLE WALL TANK(Chakdl 111 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (CMck me iwn mly) ❑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 INVENTQRY RECONCILIATION ❑ B TANK TESTING (SIR)BIENNIAL TANK TESTING ❑❑ 99 OTHER 3 MANUAL MONITORING 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? 459 ❑Yes ❑ No UPCF(12/99 revised)