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Am Alk I UNIFIED PROGRAM CONSOLIDATEDk FAM O Sa UNDERGROUND STORAGE TANK OI/14/1001 OPERATING PERMIT APPLICATION-TANK INFORMATION(one form per UST) TYPE OF ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Sections 1,II,III,IV,and IX below) 430 ❑ 1.NEW PERMIT ❑ 3.RENEWAL PERMIT ® 5.CHANGE OF INFORMATION ❑ &TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE ON SITE ❑ 8.UST REMOVAL (CX DATE UST PERMANENTLY CLOSED: 431a DATE EXISTING UST DISCOVERED: 4306 L FACILITY INFORMATION FACILITY ID#(Agency Use Only) _ I BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 Spirit Gasoline BUSINESS SITE ADDRESS103 CITY 104 1250 North Wilson WayStockton II.TANK DESCRIPTION TANK ID# 1 Mldgrade �T2�432 TA NK MAN UFAC IURER 433 TANK CONFIGURATION: "1HISTANKIS 434 / /l Modem Welding ®I.ASTAND-ALONE TANK d E]2.ONE M A COMPARTMENTED UNIT. q- 4Co fete one page 6wsm r each m nnt in the unit. DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 036 NUMBER OF COMPARTMENTS IN THE UNIT 437 r lq Cl 12,000 1 III.TANK USE AND CONTENTS TANK USE N la.MOTOR VEHICLE FUELING ❑ It.MARINA FUELING ❑ Ic.AVIATION FUELING 439 i ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WASTE(Includes Used Oil) ❑ 5.EMERGENCY GENERATOR FUEL[HSC§25281 5(c)I ❑ 6.OTHER GENERATOR FUEL ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 439a CONTENTS PETROLEUM: ❑ la.REGULAR UNLEADED ® Ic.MIDGRADE UNLEADED ❑ Ib.PREMIUM UNLEADED 440 ❑ 3.DIESEL ❑ 5.JET FUEL ❑ 6.AVIATION GAS ❑ 8.PETROLEUM BLEND FUEL - ❑ 9.OTHER PETROLEUM (Specify): 440a NON-PETROLEUM:❑ 7.USED OIL ❑ 10.ETHANOL ❑ 11,OTHER NON-PETROLEUM(Specify): 4406 IV. TANK CONSTRUCTION TYPE OF TANK ❑ I.SINGLE WALL N 2.DOUBLE WALL ❑ 95,UNKNOWN 443 PRIMARY CONTAINMENT ® LSIEEL ❑ 3.FIBERGLASS ❑ 6.INTERNAL BLADDER 444 ❑ 7.STEEL+INTERNAL LINING ❑ 95.UNKNOWN ❑ 99.OTHER (Specify): 444a SECONDARY CONTAINMENT N 1.STEEL ❑3.FIBERGLASS ❑ 6.EXTERIOR MEMBRANE LINER ❑ 7.JACKETED 445 ❑ 90.NONE ❑ 95.UNKNOWN ❑99.OTHER(Specify): 445a OVERFILL PREVENTION N 1.AUDIBLE&VISUAL ALARMS ❑ 2.BALL FLOAT ❑ 3.FILL TUBE SHUT-OFF VALVE 45F ❑ 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT/WASTE PIPING CONSTRUCTION, PIPING CONSTRUCTION ❑I.SINGLE-WALLED N 2.DOIJ131.F-WALLED [199.OTHER 460 SYSTEM TYPE N 1.PRESSURE ❑ 2.GRAVIT} ❑ 3.CONVENTIONAL SUCTION ❑ 4.SAFE SUCTION 123 CCR§2636(a)(3)] 458 PRIMARY CONTAINMENT ❑ L STEEL N 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 464 ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464a SECONDARY CONTAINMENT ❑ I.STEEL N 4.FIBERGLASS ❑ 8.FLEXIBLE ❑ 10.RIGID PLASTIC 46,11, ❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER(Specify): 464e PIPING/TURBINE CONTAINMENT SUMP TYPE ❑ I.SINGLE WALL N 2.DOUBLE.WALL ❑ 90.NONE 464d VI.VENT,VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT ❑ L STEEL N 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.011 IEE(Specify) 464c 464e1 VENT SECONDARY CONTAINMENT ❑ 1.STEEL 1 4.FIBERGLASS ❑ 10.RIGID PLASTIC �.90.NONE ❑ 99.OTHER(Specify) 464f 464171 VR PRIMARY CONTAINMENT ❑ L STEEL N 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 4648 464111 VR SECONDARY CONTAINMENT ❑ 1.STEEL 1 4.FIBERGLASS ❑ 10.RIGID PLASTIC 1190.NONE ❑ 99.OTHER(Specify) 464h 464hl VENT PIPING TRANSITION SUMP TYPE 49 1.SINGLE WALL ❑ 2.DOUBLE WALL • 90.NONE - 4641. RISER PRIMARY CONTAINMENT 1.STEEL 4.FIBER01 ASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 4641 464 1 RISER SECONDARY CONTAINMENT ❑ L STEEL N 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify) 464k 4Mkl FILL COMPONENTS INSTALLED N I.SPILL BUCKET W 3.STRIKER PLATE/BOTTOM PROTECTOR EA 4.CONTAINMENT SUMP 45la-c VII.UNDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE N 1"SINGLE WALI. ❑ 2.DOUBLE WAI 1. ❑ 3.NO DISPENSERS ❑ 90.NONE 469a CONSTRUCTION MATERIAL ❑ LSTEEL N 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 99 OFIIER(Specify) 469bc VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT 2K6.ISOLATION 448 IX. APPLICANT SIGNATURE CERTIFICATION: I certify that this UST system is compatible with the hazardous substance stored and that the information provided herein is true,accurate, and in full compliance with legal re uirements APPLICANT SIGNATURE �rD � �� L DATE 9/16/2009 470 APPLICANT NAME(print) Jojinder Lal ,ss !"6? f.C7�r/Z 471. APPLICANTTITLE Owner/Operator 472. UPCF UST-B-I/2 Rev.(12/2007)