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04/26/2012 TUE 10: 19 FAX 705206 < 'I �b I 1� ��/Bp5Jc 2 4 UNIFIED PROGRAM CONSOLIDATED FORM 11 2 UNDERGROUND STORAGE TANK Ak/ OPERATING PERMIT APPLICATION-TANK INFORMA N(one farm per UST) TYPE OP ACTION (Check one item only. For an UST permanent closure or removal,complete only this section and Soclions 1,11,Ill,IV,and IX bclow) ® I.NEW PERMIT ❑ 3,RENBWALPERMIT ❑ 5.CHANOE OF INFORMATION 6.TEMPORARYUST CLOSURE ❑ 7,USTPERMANENT CLOSURE ONSITE O 8.UST REMOVAL PATE UST PERMANENTLY CLOSED! °70i DATE EXISTING UST DISCOVRRSD: dice " -. . . . - , FACILITY ID N(Agency Usa Only) BUSINESS NAME(Same as FACILITY NAME or DDA-Doing Business As) 1 Spirit Gasoline BUSINESS SITE ADDRESSIm CITY Joe 1250 North Wilson Way Stockton M.Mij TANK IDN Tank 2-Midgrade. 412 TANK MANUFACTURER 417 TANIt CONFIGURATION: 'MISTANK IS 439 n S Modem Welding 0 LAsrAND-ALoNETANK �/") [:12.ONE M A COMPARTMENTED UNIT. I4u SET uch cel. nen In:h°wll. DATE UST SYSTEM INSTALLED 05 TANK CAPACITY IN GALLONS 45 NIIM,SE OF COMPARTMENTS IN THE UN IT D7 4/1/95 12000 yy� 1 TANK USE ® I&MOTORVEIBCLBFURLJNG U Ib.MARINA FUELING Q 10.AVIATIO 15' n • - N PUBLItN3 av O 3.CHBMICALPRODUCTSTORAGE D 4.WARDOUS WASTE p.41.4m mw 011) U S.EMERGENCY GENERATOR POHL InscgafxlLs(e)) Q 6,OTHBR GENERATOR FUEL D95.UNKNOWN D90.OTHER( i ): 4394 CONTENTS PETROLEUM: Q ILREGULARUNLEADED ® fo.MIDORADEUNLHADED ❑ Ib.PREMIUM UNLEADED 440 D 3.Dle$BL D S.JETFUEL D 6.AVIATION GAS Q 0.PBTKOLBUM BLEND PURL D 9.0711BRPETROLEUM rel 4466 NONRUTROLEUM:D 7.USED OIL U 10.MANDL U 11.OTHER NON-PETROLIUM if : 440b TYPE OF TANK U 1.SINGLE WALL ® 2,DOUBLE WALL` p • •, 9t.UNKNOWN 443 PRIMARY CONTAINMENT 0 1.VASL 0 3.FIBERGLASS D 6.INTERNAL BLADDER 444 U 7.STEM+INTRIWAL LINING Q 95.UNKNOWN U 99.OTHER 1 4444 SbCONDARY CONTAINMENT Q 1.9TaEL ®3.FIBERGLASS D 6.BXTHRIORMDMBRANSLINER ❑ 7.IA(9(ETED 445 U 90.NONE Q 95.UNKNOWN Q 99,U REE(Specify): 4454 OVERFILL PREVENTION 3 I.AUDIBLE h VISUAL ALARMS U 2.BALLFLOAT Q 3.FILL TUBE SHUT-OFF VALVE 432. C34.TANK M5&S REQUIREMEMS FOK%7 SMPTiON PROM OVBRPI LL PRSVEN)TON RQOIPMSNT (MING CONSTRUCTION D 1.ISINOLB.W ALLBD ®2.DOUBLE-WALLED U 99.OTHBR 460 SYSTEM TYPE I.PRESSURE 0 2.GRAVITY C3 3.CONVENTIONAL SUCTION U 4.SAPSSUCnONII2)CCJtf26)6(aMi)j 451 PRIMARYCONfA1NMBNT ❑ I.STEEL ® 4,FIBERGLASS U 8.FLEXIBLE U 10.111OWPIASTIC 464 Q 90.NONE D 95.UNKNOWN D 99.OTEER 4e( ! 464. SECONDARY CONTAINMENT D 1,STEEL ® 4.FIBERGLASS U 0.FLEXIBLH in 10.RIGIDPLASTIC 464b D 90•NONE U 93.UNKNOWN Q 99.OTHER jEnta, 464c PIPtNGn11RBfNE CONTAINMENT SUMP TYPO 1.SINOLB IVALL 2 DOUBLE WALL 90.NONE e Vif4'1!F71Y7, VOWW1.0::'4 � ..,s. VENT PRIMARY CONTAINMENT U 1,bTEEL VA 4•FIBBROLASS U 10.IWAL)PLASTIC IJ 0.NONE Cl 99.Ufap,(Speelfy) 460 /6kl VENT SECONDARY CONTAINMENT 1.STSEL 4,FIOBROLASS 10.RIGID PLASTIC 90.NONE 99.OTJJBR(SyeOlfy) 464 ,eon VR PRIMARY CONTAINMENT (.STEEL 0 4.FMBROLASS 0 10.RIGIOPLASTIC 0 90.14ONC 5ROTHER(Specify) 4Ns 4"111 VR SECONDARY CONTAINMENT U 1.STEEL 0 4,FIB13RGLASS 10.RIGID PLASTIC 90.NONB 9p.OTHER(Specify) 464h Who VENT PIPINOTRANSITION SUMPTYPH LSINOLBWALL 2.DOUBLE WALL 90.NONE 464L RISER PRIMA RVCONTAINMIINTU I.STEEL I@ 4PIBBROLASS E3 10.RIGID PLASTIC U 90.NONE 99,OTHER(Specify) 464j 464 1 RISER SECONDARY CONTAINMENT 1.9TBEL 6.PIBIIRGLASS 10.RIGID PLASTIC 90.NONe 99.OTFIDR(Spccify) Wk 4Rk1 FILL COMPONENTS INSTALLED I.SPILL SUCI4ET 0 3.STRIKER PLATIVROTOOM PROTECTOR U 4.CONTAINMENT-SUMP 4514i CONSTRUCTION TYPE M L$rNGLB WALL U 2.DOUBLE WALL ❑ 7.NO DISPHNSER9 U 90.♦NONE CONSTRUCTION MATERIAL 1.9T08L 0 4,P®BROLASS 3 10� .RIGID • v�.'� ::5.!:.i:7j•f .�'!•�r 1V[•4Ti'. PLASTIC U..`99.0 :-.A1)','•T�FrE,;3.R:. I • tic - r;: STEEL COMPONENT PA(yrRCON D 2.SACRIFICIAL ANODE(S) Q 4.1MAUSSED M4nf.4: 6:•,�.1 69b•s CURRBNr Q 6,ISOLATION 44a 77kJtf f1�. •1 J: ' S',L'', CERTIFICATION! 1 certify that this UST aystom Is compatible with the haaardous substi m:e stored and t rt the Information pmvl#W herein is Jrua,•aceunt6, and In NII consBanco with festal irgilvilremomto. APPLICANT SIGNATURE t-r O n _Jl n DATE APPLICANT NAME(print) 7oginder Lal -0C /N1J)D Erg 001" APFLICANTTITLE Operator � A72. :To 4 UPCP UST-9-112 1` �V O Rev.(11W2001)