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UN ,D PROGRAM CONSOLIDATED FORMWO UNDERGROUND STORAGE TANKS - TANK 1 TANKS /�,{/ (two pages per tank) TYPE OF ACTION ❑ 1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT / �t Page 2 of 10 (Check Doty Hon Doty) v CHIN E OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE (Spenfrr ynson-fll or ocaise. 5 u El 7 PERMANENTLY CLOSED ON SITE El 3RENEWAL PERMIT only) ( pc fyrewon-.for)oealuae only)•. ❑8TANK REMOVED +30 BUSINESS NAME(Same a FACILITY NAME or DBA-Doing Business As) I FACILITY ID: 1 ARCO FACILITY#6335" 3 FA0007571 LOCATION WITHIN SITE(Optional) 431 S S. HIKH 9q �dc IC PHONE 2� L 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# � 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK XERXES ❑Yes ❑No +34 If"Yea",co Ine Doe a for each co t. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 3/16/1998 10,000 43J ADDITIONAL DESCRIPTION(For IoW use Doty) 438 II.TANK CONTENTS TANK USE 439 PETROLEUM TYPE ® L MOTOR VEHICLE FUEL ❑ la.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL 440 (](marked towline Petroleum Type) ® 16.PREMIUM UNLEADED ❑3.DIESEL ❑ 6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ I c.MIDGRADE UNLEADED ❑ 4.GASOHOL ❑ 99.OTHER ❑3.CHEMICAL PRODUCT COMMON NAME fiom Hamrdous Materials Iovento ❑4.HAZARDOUS WASTE ( ry Page) 4+1 CAS#(morn xaaardous Materials Inventory page) P12 (Indudn Used a>) ❑9s.UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM a43 (Check one item only) EXTERIOR MEMBRANE LATER ❑ 95.UNKNOWN ®2.DOUBLE WALL ❑4.SINGLE WALL IN VAULT ❑99.OTHER TANK MATERIAL-primary tank ❑ 1.BARE STEEL ®FIBERGLASS/PLASTIC ❑ S.CONCRETE ❑ 95.UNKNOWN 4a4 (Checkone itnnonly) ❑ 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 ❑ S.CONCRETE ❑ 95.UNKNOWN 445 (Check one item only) ❑ 2.STAINLESS STEEL ❑ 4.STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTBLE W/100"/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 447 OR COATING (Check one nem only) ❑2 ALKYD LINING ❑ 4 PHENOLIC LININGEl99.OTHER ® 6UNLINED (For local we only) OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC ® 3 F RGLAS ORCED PLASTIC El 95 UNKNOWN 44g DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION (Check one item only) El IMPRESSED CURRENT El 99 OTHER ❑ 2 SACRIFICIAL ANODE (For IoW use Doty) SPILL AND OVERFILL � YEAR INSTALLED 450 TYPE(local we only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (ChI] ' Seck all that apply) , PILL CONTAINMENT 1998 ❑ 1 ALARM V LL TUBE SHUT OFF VALVE 5?2 DROP TUBE El3STRIKER PLATE ❑ 2BALL FLOAT ❑4EXEMPT Oqwb(D N.TANK LEAK DETECTION(A tacription ofthe aannoring program shall ba sulani ted to the local agency) IF SINGLE WALL TANK(Check all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Check one nem Indy) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑ 6 VADOSE ZONE ❑ 1 VISUAL(SINGLE WALL IN VAULT ONLY) ❑3 CONTINUOUS ATG ❑ 7 GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑ 4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING El 3 MANUAL MONITORING (SIR)BIENNIAL TANK TESTING El 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 atallons ❑Yes ❑ No UPCF(12/99 revised)