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UE231 A �( UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK iO OPERATING PERMIT APPLICATION-TANK INFORMATION(one form per UST) 0 TYPE OF'ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections 1,11,111,IV,and IX below) 430 p1 N I.NEW PERMIT ❑ 3.RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ S.UST REMOVAL DATE UST PERMANENTLY CLOSED: 4303 1 DATE EXISTING UST DISCOVERED: 4106 I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) T ^ /t7Fp n _ _ I BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) C I� (� 2-03 AT&T Corp. UE231 C G (7 BUSINESS SITE ADDRESS 103 1 CITY ,7 ,/y 104 1 I0 W TURNER RD#1 Lodi l� IL TANK DESCRIPTION QM�I TANK BD# a32 TANK MANUFACTURER 433 TANK CONFIGURATION: TI IIS TANK IS 5- /V1 G�(1 434 UE231AO07 Unknown ®1.ASTAND-ALONETANK 45-6 0 e] I J T/I R 1� 1^ O` El2.ONE IN A COMPARTMENTED UN IT. A V _l J Co lete orm page for each cumurtment in the unit. DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437 1/2001 300 1 III.TANK USE AND CONTENTS TANK USE ❑ la.MOTOR VEHICLE FUELING ❑ Ib.MARINA FUELING ❑ Ie.AVIATION FUELING 439 ❑ 3.CHEMICAL PRODUCT STORAGE ❑'4.HAZARDOUS WASTE(Includes Used Oil) ® 5.EMERGENCY GENERATOR FUEL[HSC k25281.5(el ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 439a CONTENTS PETROLEUM: ❑ Ia.REGULAR UNLEADED ❑ I,MIDGRADE UNLEADED ❑ Ib.PREMIUM UNLEADED 440 ® 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM (Specify): 440+ NON-PETROLEUM:❑ 7.USED OIL ❑ l0.ETHANOL ❑ II.OTHER NON-PETROLEUM(S c6if): 4406 IV. TANK CONSTRUCTION TYPEOFTANK 10 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 95.UNKNOWN 443 PRIMARY CONTAINMENT ® 1.STEEL ❑ 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 444 ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (S eeify): 4443 SECONDARY CONTAINMENT ❑ 1.STEEL [13.FIBERGLASS ❑ &EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445 ® 90.NONE ❑ 95.UNKNOWN Q 99.OTHER(Spccify): 445n OVERFILL PREVENTION ❑ 1.AUDIBLE&VISUAL ALARMS 0 BALL FLOAT ❑ 3.FILL TUBE SHUT-OFF VALVE 452. ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT/WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION ❑I.SINGLE-WALLED Q 2.DOUBLE-WALLED (199-OTHER 460 SYSTEM TYPE ❑ I..PRESSURE ❑ 2.GRAVITY ® 3.CONVENTIONAL SUCTION Q 4.SAFE SUCTION[23 CCR 4263Q.)(3)j 458 PRIMARY CONTAINMENT I.STEEL ❑ 4.FIBERGLASS El S.FLEXIBLE 0 10.RIGID PLASTIC 464 Q 90.NONE Q 95.UNKNOWN El 99.OTHER(S cif(): 464''3' SECONDARY CONTAINMENT ❑ 1.STEEL Ej 4.FIBERGLASS Q S.FLEXIBLE ❑ I0.RIGID PLASTIC 4641, 1990.NONE [195.UNKNOWN ❑. 99,OTHER(Specify): 464, PIPING/TURBINE CONTAINMENT SUMP TYPE D1.SINGLE WALL [I Z.DOUBLE WALL CR90.NONE 464d VI.VENT,VAPOR RECOVERY(VR)AND RISER I FILL.PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT 0 1.STEEL ❑ 4.FIBERGLASS ❑ t0:RIGID PLASTIC ❑. 90.NONE ❑ 99.OTHER(Specify). 464c 464.1 VENT SECONDARY CONTAINMENT 0 1.STEEL ❑ 4.FIBERGLASS El 10'.RIGID PLASTIC ®' 90.NONE ❑. 99.OTHER(Specify) 46417 1640 VR PRIMARY CONTAINMENT ❑' I.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC E[ 90:NONE ❑ 99.OTHER(Speeify) 4643 4640 VR SECONDARY CONTAINMENT Q I.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC C9 90.NONE ❑ 99.OTHER(Specify)` 41 th 46461 VENT PIPING TRANSITION SUMPTYPE Q I.SINGLE WALL ❑ 2DOUBLEWALL El 90.NONE 464i. RISER PRIMARY CONTAINMENT ❑ I.STEEL ❑ 4.FIBERGLASS ❑ 10 RIGID PLASTIC ®:'90.NONE ❑ 99.OTHER(Specify) 4641' 46411 RISER SECONDARY CONTAINMENT ❑ I.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE ❑ 94..OTHER(Spcclfy). 464k 464k1 FILL COMPONENTS INSTALLED ❑ L SPILL BUCKET ❑. 3..STRIKER PLATE/BOTTOM PROTECTOR ❑ 4.CONTAINMENT SUMP' 4513-= VII.UNDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE Q' I.SMGLE WALL [:1 DOUBLE WALL ®' 3.NO DISPENSERS ❑' 90:NONE 46% CONSTRUCTION MATERIAL I.STEFL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99.OTHER(Spceify) 4694e VDI. CORROSION PROTECTION STEEL COMPONENT PROTECTION [I 2'.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT- El 6..ISOLATION U{.. APPLICAIN.T SIGNATURE.. CERTIFICATION.1 certify that this UST system i ampatihle with the hazardous substance stored and that the information provided herein is true,accurate, andin full compliance with, re uir APPLICANT SIGNATURE DATE 470' 5/22/2012 APPLICANT NAME(print) 071 APPLICANT TITLE. 472 Steven J Hall Manager, EH&S e9 nanX- �7 USCF UST-B a d V U, -71311'L Rev.(1212007)