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UE231 1( UNIFIED PROGRAM CONSOLIDATED FORM ( UNDERGROUNDSTORAGETANK OPERATING PERMIT APPLICATION-TANK INFORMATION(One form per UST) N TYPE OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections I,11,111,IV,and IX below) 430 JVk ❑ I.NEW PERMIT ❑ 3.RENEWAL PERMIT ® 5.CHANGE OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST REMOVAL DATE UST PERMANENTLY CLOSED: '430° 1 DATE EXISTING UST DISCOVERED: 430b I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) FA /Iyr, U&I 1 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) // rl,o D I 3 AT&T Corp. UE231 C Fj !� BUSINESS SITE ADDRESS 103 1 CITY rj QM�4 110 W TURNER RD#J Lodi .) II.TANK DESCRIPTION 7 TANK ID# 432 TANK MANUFACTURER 433 TANK CONFIGURATION: TIAs TANK IS n� J 434 UE231AO06 Unknown ®1.ASTAND-ALONE TANK } �� ❑2.ONE N A COMPARTMENTED UNIT. SR vl Ca Inc one .,far each com nmem in the wit. DATE U9T SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437 1/2000 120 1 III.TANK USE AND CONTENTS TANK USE ❑ Ia.MOTOR VEHICLE FUELING ❑ Ib.MARINA FUELING 0 Ic.AVIATION FUELING 439 03.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE OnddsUsedOil) 05.EMERGENCY GENERATOR FUEL[HSC g252sL5(l)] 0 6-OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 439, CONTENTS PETROLEUM: 0 Ia.REGULAR UNLEADED ❑ Ic.MIDGRADE UNLEADED 0 Ib.PREMIUM UNLEADED 140 ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ 8.PETROLEUM BLEND FUEL EI 9.OTHER PETROLEUM (Specify): Lube Oil a a0 NON-PETROLEUM:❑ 7.USED OIL 0 10.ETHANOL 0 I L OTHERNON-PETROLEUM(Specify): 440b IV. TANK CONSTRUCTION TYPEOFTANK ® I.SINGLE WALL 02.DOUBLEWALL 095.UNKNOWN 443 PRIMARY CONTAINMENT ® 1.STEEL 0 3.FIBERGLASS 0 6-INTERNAL BLADDER 446 0 7.STEEL,INTERNAL LINING 0 95.UNKNOWN 0 99.OTHER S cci ): 444° SECONDARY CONTAINMENT 0 1.STEEL ❑3.FIBERGLASS 0 G EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445 0 90.NONE 0 95.UNKNOWN 099.OTHER(Specify): 445. OVERFILL PREVENTION OI.AUDIBLE&VISUAL ALARMS 02.BALL FLOAT 03.FILL TUBE SHUT-OFF VALVE 452. 0 4-TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT[WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION ❑1.SINGLE-WALLED ❑2.DOUBLE-WALLED 0 99.OTHER 460 SYSTEM TYPE 0 1.PRESSURE 0 2.GRAVITY ® 3..CONVENTIONAL SUCTION ❑ 4'.SAFE SUCTION[23 CCR§2636(.)(3)1 458 PRIMARY CONTAINMENT N 1.STEEL 0 4.FIBERGLASS 0 S.FLEXIBLE 0 I0.RIGID PLASTIC 464 ❑ 90.NONE 0 95.UNKNOWN 0. 99.OTHER(Specify): 464. SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ R.FLEXIBLE 0 10.RIGID PLASTIC 464b - ® 90..NONE El 95.UNKNOWN 0 99.OTHER(Spccify): 464" PIPING/TURBINE CONTAINMENT SUMP TYPE 0 1.SINGLE WALL. ❑ 2.DOUBLE WALL iN 90.NONE 4644 VI.VEN'T',VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT 0 I.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC 0 90,NONE 0 99.OTHER(Spceify) 464e 464e1 VENT SECONDARY CONTAINMENT O, 1.STEEL 04.FIBERGLASS 010.RIGID PLASTIC 090,NONE [199.OTHER Xpcciiy) 464f 464fl VR PRIMARY CONTAINMENT 0 1.STEEL ❑ 4.FIBERGLASS 0 10.RIGID PLASTIC 0 90.NONE ❑ 99.OTHER(SPc6fy) 4648 46a.t VR SECONDARY CONTAINMENT ❑. I.STEEL 0' 4.FIBERGLASS ❑ 10.RIGID PLASTIC 10 90.NONE 0 99'.OTHER(Spccify). 464h 4Mh1' VENT PIPING TRANSITION SUMP TYPE 01.SINGLE WALL El.DOUBLE WALL 090_NONE. 464,. RISER PRIMARY CONTAINMENT 0, 1.STEEL ❑ 4.FIBERGLASS ❑ IO.RIGID PLASTIC 0 90,NONE 0 99..OTHER($'pccify) 4641 4641 RISER SECONDARY CONTAINMENT 0J 1.STEEL ❑ 4.FIBERGLASS 0' 10.RIGID PLASTIC ®'. 90.NONE 0 99.OTHER(Specify) 464k 464k1' FILL COMPONENTS INSTALLED 0. I.SPILL BUCKET 0 3.STRIKER PLATE/BOTTOM PROTECTOR 0 4.CONTAINMENT'SUMP 451.-e VII.UNDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE 0', 1..SINGLE WALL ❑ 2.DOUBLE WALL 0 3,NO DISPENSERS ❑ 90.NONE 469 CONSTRUCTION MATERIAL 0 I.STEEL 0 4:.FIBERGLASS ❑ 10.RIGID PLASTIC 0.99.OTHER(S eci ) 469h'e VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION 0. 2..SACRIFICIAL ANODES) 0' 4.IMPRESSEDCURRENT 06.ISOLATION 948` LSI_ APPLICANT SIGNATURE. CERTIFICATION:'.I certify that this UST system i ompatible with the Hazardous'substance staredand that the information provided herein istrue,accurate, and in full comp Bance with re uir APPLICANT SIGNATURE DATE 470: 5/2Z/2012 APPLICANT NAME(print) 411. APPLICANTTYrLE 471. Steven J Hall Manager,,&H81S,,rn9, .fv`say"o�il� UPCF UST-B -7131 V L 20'Rev.(12/2007)