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WTWIED PROGRAM CONSOLIDATED FOR. ` UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATION (O e form pe US > TYPE OF ACTION (Check one item only. For a UST closure or removal,complete only this section and Sections 1,17,117,IV,and IX below) 430. ❑ 1.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: 430a. I DATE EXISTING UST DISCOVERED: 430b. I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) (� 1 BUSINESS NAME(Same as Facility Name or DBA-Doing Business As) 3. Pacific Gas and Electric Company, Stockton Service Center BUSINESS SITE ADDRESS 103. 1 CITY 104. 4040 West Lane Stockton II. TANK DESCRIPTION TANK ID# 432 TANK MANUFACTURER 433 TANK CONFIGURATION:THIS TANK IS 434 �'�' 3n Modern Welding ® 1.A STAND-ALONE TANK Complete one page for each ❑ 2.ONE IN A COMPARTMENTED UNIT compartment in the unit. DATE UST SYSTEM INSTALLED 435. TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS IN THE UNIT 437. R -44fW I Deo 1 III. TANK USE AND CONTENTS TANK USE ❑ la.MOTOR VEHICLE FUELING ❑ 1b.MARINA FUELING ❑ lc.AVIATION FUELING 439. ❑ 3.CHEMICAL PRODUCT STORAGE ® 4.HAZARDOUS WASTE(Includes Used Oil) ❑ 5.EMERGENCY GENERATOR FUEL[HSC§25281.5(c)] ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OT[-CER(Specify): 439a. ..............................................................................................................................................................................................................................._...._..........._......__........................_...._................._........_._._..._......................................_................_...._......... _._.._..... CONTENTS PETROLEUM: ❑ la.REGULAR UNLEADED ❑ lc.MIDGRADE UNLEADED ❑ lb.PREMIUM UNLEADED 410. ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ 8.PETROLEUM BLEND FUEL ® 9.OTHER PETROLEUM(Specify): used motor oil 440a. ....................._ _.__...._.................................................................................................................................................................................................... _......__._..._............_.._........_............_......_..._.. _.._.. ............................._....__. NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL ❑ 11.OTHER NON-PETROLEUM(Specify): 440b. IV. TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 95.UNKNOWN 413• ......................................................................................... PRIMARY CONTAINMENT ® 1.STEEL ❑ 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 414. ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 444a. SECONDARY CONTAINMENT ® l.STEEL ❑3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445. ❑ 90.NONE ❑ 95.UNKNOWN ❑99.OTHER(Specify): 445a. OVERFILL PREVENTION ❑ 1.AUDIBLE&VISUAL ALARMS ❑ 2.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 ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 99.OTHER 460. ....................._..............._..........._.................._......................_..-..........__.........................................................._... .............._.........__......................._._._....._......._........................ . SYSTEM TYPE ❑ 1.PRESSURE ® 2.GRAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION[23 CCR§2636(a)(3)] 458. ............................................. .................................................................._......................................._............................._.........._.._................. ._. .................................... .......................................................................................................... .. PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE 10.RIGID PLASTIC 464. _ ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464a. ... ............................................................................................................................................_._..__.._...._..........__._.......__............................. SECONDARY CONTAINMENT ❑ 1.STEEL N 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464b. ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464c. PIPING/TURBINE CONTAINMENT SUMP TYPE ® 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 90.NONE 464d. VI. VENT,VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): 4464e. ....................................................................__.............................................._......._...-.._......_.... ..._.__._..............._.......................- VENT SECONDARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): 44464f. .........................................----............................................__..._..............._............._._..................................................................................................................._..............................................................._..._......-....._....._...................................................................._.............. ....4�......... VR PRIMARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE ❑ 99.OTHER(Specify): 46451 . .__..................................................._..............................................................------.......---------......................._..........._..................._......._.............-----------........................................._...................---...... VR SECONDARY CONTAINMENT [31.STEEL [14.FIBERGLASS [110.RIGID 464h.PLASTIC ® 90.NONE ❑ 99.OTHER(Specify): 464ht VENT PIPING TRANSITION SUMP TYPE ❑ 1.SINGLE WALL ❑ 2.DOUBLE WALL ® 90.NONE 464'. ........._._...._...................................._._...............----_ __.-............._._._..-__..._-_ --._._ _. ..._..._........_.....-- --..... -._........-_... RISER PRIMARY CONTAINMENT ® 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): 464. _ ...__....._............_......._..._._..-.__ --..._...-- .._....._.. -------- - -- `�'t-�b411. RISER SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC ® 90.NONE [399.OTHER(Specify): F^.4�4k1. _.....-_..........._.._........._......._. _-----.._.. _.................................................................._._._.._....__..._._..................................----.....-..-----...._..............__....................._........._............._.___.. FILL COMPONENTS INSTALLED ® 1.SPILL BUCKET ® 3.STRIKER PLATEIBOTTOM PROTECTOR ❑ 4.CONTAINMENT SUMP la-c. VII. UNDER DISPENSER CONTAINMENT (UDC) CONSTRUCTION TYPE_ - ❑ 1.SINGLE WALL ❑ 2.DOUBLE WALL ® 3.NO DISPENSERS ❑ 90.NONE :-'469a. CONSTRUCTION MATERIAL ❑ 1.STEEL [14.FIBERGLASS [110.RIGID PLASTIC [199.OTHER(Specify) E__34646469c.469c. VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT ® 6.ISOLATION 418. IX. APPLICANT SIGNATURE CERTIFICATION: I certify that this UST system is comp tible with the hazardous substance stored and that the information provided her rue, accurate,Md in full m Iia ce voWe&requirements. APPLICANT SIGNATURE DATE 11/24/2008 470. APPLICANT NAME(print) Michelle Le V 471. APPLICANT TITLE Environmental Specialist 472 UPCF UST-B Rev.(12/2007)-1/2 www.unidocs.org