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4 IFIED PROGRAM CONSOLIDATED FORN9 TANK: TA0196308 PR N: PRO231963 UNDERGROUND STORAGE TANKS - TANK PAGE 1 FAC N FA0006445 (two pages per tank) TYPE OF ACTION ❑ INEW SITE PERMIT ❑ 4"ENDED PERMIT ❑ 5CHANGE OF INFORMATIONPage 2 of9 (Ch oniv item only) ❑ 6TEMPOAARY SITE CLOSURE ❑ r PERMANENTLY CLOSED ON SIT ❑ JRENEWAL PERMIT ❑ aTANK REMOVED 4 BUSINESS NAME Isaac m FACILITY NAME or DBA-Dong Buci—As) FACILITY ID: FIR#: P G&E STOCKTON SERVICE CTR 3 FA0006445 PR0231963 LOCATION WITHIN SITE(Dpeo,st) 4040 WEST LN,STOCKTON PHONE V L TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings and landmarks shall he submitted to the local agency.) TANK ID# Tank#: 8 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yes ❑No 434 1�\ TA0196308 v^Ya wmpw,pne page r calk<ompamnunt. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 431 1,000 ADDITIONAL DESCRIPTION(For lad...1,) 43a IL TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ❑ L MOTOR VEHICLE FUEL ❑ la.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL (Ifmvketl wmplar Punplcum 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(fmm Huardo n M.uns Emanon page) 441 CAS#(fian Hozallous Marmots Inientow page) 442 ®4.HAZARDOUS WASTE (Includes ass d Oil) ❑95.UNKNOWN III.TANK CONSTRUCTION TYPEOFTANK 1,SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Ckk one nein ant.) EXTERIOR MEMBRANE LINER E] 95 UNKNOWN ®2.DOUBLE WALL ❑ 4.SINGLE WALL M VAULT ❑ 99,OTHER TANK MATERIAL-primary lank ❑ 1.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN d44 (Chcd,orcnemonk) ❑ 2.STAINLESS STEEL ❑ STEEL CLAD W/FIBERGLASS ❑ 8.FRPCOMPTIBLEW/100%METHANOL REINFORCED PLASTIC(FREI ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ I.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE [-195,UNKNOWN 445 (CMk one iron only) ❑2.STAINLESS STEEL ❑ 4.STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑ 99.OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ 1 RUBBER LINED ❑ 3.EPDXY LIVING ❑ 5.GLASS LINING E3 95 UNKNOWN 446 DATEINSTALLED wr OR COATING (Check om:luno on15') ❑2 ALKYD LINING ❑ 4 PHENOLIC LINING ❑ 6 UNLINED ❑ 99.OTHER (For lod use pnh) OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC ❑ 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION (Cha .itouony) ❑ 4 IMPRESSED CURRENT ❑ 99 OTHER ❑ 25ACRIFICIAL ANODE (Fm bml uscaNS'1 SPILL AND OVERFILL YEAR MSTALLE450 TYPE(kolusomly) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Cl iiff Nmappli) ❑ I SPILL CONTAINMENT ❑ IALARM ❑ 3 FILL TUBE SHUT OFF VAL` ❑ 2 DROP TUBE ❑ 2 BALL ❑ 4 EXEMPT ❑ 3STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A dnedprm ofthe mannud.sg pmgnm shall x suhminm undo 1,,cal agmom.) IF SINGLE WALL TANK(Chek all Om apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (Chak.irt only) ❑ 2 AUTOMATIC TANK GAUGING(ATG) ❑ 6VADOSE ZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 3CONTIN000S ATG ❑ ]GROUNDWATER ® 2 CONTINUOUS INTERSTITIAL MONITORING ❑ 4 STATISTICAL INVENTORY RECONCILIATION ❑ 8TANK TESTING ❑ 3 MANUAL MONITORING (SIR)BIENNIAL TANK TESTING ❑ 99 OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YRNO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL° 457 ❑ Yes ❑ No UPCF(12199 revised)