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LTKFIED PROGRAM CONSOLIDATED FO �� UNDERGROUND STORAGE TANK s J OPERATING PERMIT APPLICATION-TANK INFORMATIO ( ne form per UST) TYPE OF ACTION (Check one item only. For a UST closure or removal,complete only this section and Sections 1,11,111,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: 43W 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. Modern Welding ® 1.A STAND-ALONE TANK Complete one page for each ( d l 3 ❑ 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. 99 L-f 10,000 1 III. TANK USE AND CONTENTS TANK USE ® la.MOTOR VEHICLE FUELING ❑ Ib.MARINA FUELING ❑ 1c.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.OTHER(Specify): 439a ............................................................................__..__..__...................._.__........_......._.......__..-_.............. '-'-------.._...__............................................................._........._._... '- " .... ..... _......_........................._....... .................. CONTENTS PETROLEUM: ® la.REGULAR UNLEADED ❑ lc.MIDGRADE UNLEADED ❑ lb.PREMIUM UNLEADED 440. ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUM(Specify): 44oa. _........._..._-_... -.._......................................_._.__._._................_..-..........._..._.._......._.__...._............_................_.._.................. ...._.....-........._ _....._ 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 443. __....__._............................................................._.........._.._.._._-. - .._...._................................_..--....._._.............................._...._.........................._...._......._.........._........................................._............................_......_...._._..._...-.._...._...._.........._......_.........._._ __...................._............-....._............_.................._........................ PRIMARY CONTAINMENT kI.STEEL ❑ 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 444. _ ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 444x. SECONDARY CONTAINMENT�I.STEEL ❑3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445. ❑ 90.NONE El 95.UNKNOWN [199.OTHER(Specify): 445x. ..................._.._....__......_....._........_.................._...._._..........................................................................__.........................................................................._................. _..-........ OVERFILL PREVENTION ❑ 1.AUDIBLE&VISUAL ALARMS ❑ 2.BALL FLOAT ® 3.FILL TUBE SHUT-OFF VALVE 452• ❑ 4.TANK MEETS REQUIREMENTS POR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT/WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION ❑ 1.SINGLE WALL ® 2.DOUBLE WALL ❑ 99.OTHER 460. .. .. ..................._...._............_................._..._....--_-..._-__......------..__.-........._...._...---.---._............---.--.--..............................................................................................................................................................458. SYSTEM TYPE ® L PRESSURE ❑ 2.GRAVITY ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION 123 CCR§2636(a)(3)] ...................._...................._...---............................_......__.............._.......--.........._..........- --.._.._..............._............._...................................._........_......._.............................................................._....................................................._................._.............._................ . PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464. ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464x. SECONDARY CONTAINMENT ❑ L STEEL ® 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC a6ab. ❑ 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 464e. VENT PRIMARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): a64et. .._.._......_..........._........................................_.. -'-'--... - ._................ -._..............................._..__......._........_..----------- _-. VENT SECONDARY CONTAINMENT ❑ 1.STEEL N 4.FIBERGLASS ❑ 10.RIGID PLASTIC 464 Q 90.NONE ❑ 99.OTHER(Specify): 464fl. VR PRIMARY CONTAINMENT ❑ L STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): 464g.. ........................................_................................_................-........._........................_.-...._...............................................__._...........................__..__.._......_................................................................_._.._......-'---...._...................__..............................................._.._._.....__................................... VR SECONDARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): 464hl. _-----.........._._....._..._.._._.__....................._._... _._....._......_..........._.__..._..............:_....................-_._.._..--'- ..._....._.... -' .._....................................__....................__...._........ _.._.........................._......._........__............. ' .......-..... ,.._... 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): g6ajl_ -._.-.._........................__.....__...__ __..........._...._.........__......_....__...--'-- ----..._................................._..-_.....____.-._.......... _ - _ -_ _....................._........_....._...._.. RISER SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ ]0.RIGID PLASTIC ® 90.NONE ❑ 99.OTHER(Specify): 466g44k _....-.._...._..........-.............._................__.._.........................................._...._._...... - ..-...__...............- ----'_..__..---..................................._.__..._......._...---......_......--............._.....'- .._._..._......_.........................._.............. FILL COMPONENTS INSTALLED ® 1.SPILL BUCKET ® 3.STRIKER PLATE/BOTTOM PROTECTOR ❑ 4.CONTAINMENT SUMP 45la-c. VII. UNDER DISPENSER CONTAINMENT (UDC) CONSTRUCTION TYPE ® 1.SINGLE WALL ❑ 2.DOUBLE WALL ❑ 3,NO DISPENSERS ❑ 90.NONE 469a. CONSTRUCTION MATERIAL ® L STEEL [14.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99.OTHER(Specify) �"° 9c. VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT ® 6.ISOLATION 1 448. IX. APPLICANT SIGNATURE CERTIFICATION: I certify that this UST system is compatible with the hazardous substance stored and that the information provided here true, accurate,an null co lien R9w' h legal requirements. APPLICANT SIGNATURE -�k DATE 11/24/2008 470. APPLICANT NAME(print) Michelle Le 471. APPLICANT TITLE Environmental Specialist 472 UPCF UST-B Rev.(12/2007)-1/2 www.unidocs.org