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UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANK OPERATING PERMIT APPLICATION-TANK INFORMATION (OM form Pa LIST) TYPE OF ACTION (Check are item only. For o UST closure or removal,romplete only this section and Sections I,ll,Bl,/V,and LY below) 430_ ® 1 NEW PERMIT ❑ ; RENEWAL PERMIT ❑ 5.CHANGE OF INFORMATION 6.TEMPORARY UST CLOSURE El 7.UST PERMANENT CLOSURE ON SITE 0 S.UST REMOVAL DATE UST PERMANENTLY CLOSED: 4306 I DATE EXISTING UST DISCOVERED: 6306 I. FACILITY INFORMATION FACILITY ID#(Agency Use Only) - - 1 7 8 1 9 I BUSINESS NAME(Same as Fociliry Name or DBA-Doing BRainess As) 3. GASSPECS, INC. dba GREAT AMERICAN GAS & CAR WASH BUSINESS SITE ADDRESS 1.3 .TTY 106 2115 W. Yosemite Ave. Manteca II. TANK DESCRIPTION TANK ID# 032- TANK MANUFACTURER 433. TANK CONFIGURATION:THIS TANK IS 434. j r - CGDtRItDDtIDf SolutionsR 1.A STAND-ALONE TANK Cmy aeon pe a u L ❑ 2.ONE IN A COMPARTMENTED UNIT mrapremr N IIIc wrt. DATE UST SYSTEM INSTALLED 435 TANK CAPACITY IN GALLONS 436 1 NUMBER OF COMPARTMENTS IN THE UNIT 437 2007/12 20,000 1 III. TANK USE AND CONTENTS TANK USE R Is.MOTOR VESICLE FUELING 0 lb.MARINA FUELING 0 Ic.AVIATION FUELING 439 0 3.CHEMICAL PRODUCT STORAGE 0 4.HAZARDOUS WASTE gnclW Uv Oi0 0 5.EMERGENCY GENERATOR FUEL BLOC§25231.5(.)] 0 6.OTHER GENERATOR FUEL 0 95.UNKNOWN 0 99.ORIEL(Specify): 434 CONTENTS PETROLEUM: R la REGULAR UNLEADED 0 lc.MIDGRADE UNLEADED 0 Ib.PREMIUM UNLEADED 4a0. 0 3.DIESEL 0 5.JET FUEL ❑ 6.AVIATION GAS _ _Q 8.PETROLEUM BLEND FUEL ❑ 9.OTHER PETROLEUMS 414 NON-PETROLEUM:0 7.USED OIL 0 10.ETHANOL 11.OTHER NON-PETROLEUMS 414 IV. TANK CONSTRUCTION TYPE OF TANK 0 1.SINGLE WALL R 2.DOUBLE WALL 0 95.UNKNOWN 443. PRIMARY CONTAINMENT 0 1_STEEL R 3.FIBERGLASS 0 6.INTERNAL BLADDER 0 7.STEEL+INTERN AL LINING0 95.UNKNOWN 0 99.OTHER(Specify): 444 SECONDARY CONTAINMENT 0 1.STEEL R 3.FIBERGLASS 0 6.EXTERIOR MEMBRANE LINER 0 7.JACKETED 445. 0 90.NONE0 95.UNKNOWN 0 99.OTHER O,): MA OVERFILL PREVENTION 0 1.AUDIBLE&VISUAL ALARMS 0 2.BALL FLOAT R 3.FILL TUBE SHUT-OFF VALVE 452 0 4.TANK MEETS REQUIREMENTS FOR EXEMPTION FROM OVERFILL PREVENTION EQUIPMENT V. PRODUCT/WASTE PIPING CONSTRUCTION PIPING CONSTRUCTION 0 L SINGLE WALL R 2.DOUBLE WALL 099.OTHER 4eo. SYSTEM TYPE __---- _ R 1.PRESSURE_ p z.GRAVITY _ 0 s:coNveNrIONAL sucnoN E14.sAeE sucDON I23 aa25263s(,x3)14s3 PRIMARY CONTAINMENT 0 1.STEL 0 4.FIBERGLASS 0 S.FLEXIBLE ❑ 10.RIGID PLASTIC 0 90.NONE_ _ 0 95.UNKNOWN0 99.OTHER(Specify): 464s SECONDARY CONTAINMENT ❑ 1.STEEL R 4.FIBERGLASS ❑ 8.FLEXBiLE ❑ 10.RIGID PLASTIC gb4c� 0 90.NONE 0 95.UNKNOWN ❑ 99.OTHER(Specify): 4s1. PIPING/I'URBINE CONTAINMENT SUMP TYPE 0 I.SINGLE WALL R 2.DOUBLE WALL 0 90.NONE qbm_ VI. VENT, VAPOR RECOVERY(VR)AND RISER/FILL PIPE PIPING CONSTRUCTION VENT PRIMARY CONTAINMENT 0 1.STEEL R 4.FIBERGLASS 0 10.RIGID PLASTIC 0 90.NONE 0 99.OTHER(Specify} a4sael ____-__ __--.______.__...... _.......__..._--0- _..........._.. ..._..._.._...._. ..._..__-.__.___ _____ _fir.. VENT SECONDARY CONTAINMENT ❑ L STEEL R 4.FIBERGLASS 0 10 RIGID PLASTIC ❑ 90.NONE 0 99.OTHER(Specify): X90 VR PRIMARY CONTAINMENT ❑ 1 S I EEL R 4 FIBERGLASS ❑ 10 RIGID PLASTIC ❑ 90.NONE 0 99.OTHER(Specify): 460 VR SECONDARY CONTAINMENT ❑ L STEEL R 4.FIBERGLASS ❑ 10.RIGID PLASTIC 0 90.NONE 0 99.OTHER(Specify} 4646 ........_...._.-.____� 1. VENT PIPING TRANSrT10N SUMP TYPE ❑ 1.SINGLE WALL R 2.DOUBLE WALL [190.NONE RISER PRIMARY CONTAINMENT R 1.STEEL 0 4.FIBERGLASS 0 10.RIGID PLASTIC 0 90.NONE 0 99.OTHER(Specify): 4=1j RISER SECONDARY CONTAINMENT ❑ 1.STEEL ® 4.FIBERGLASS [110.RIGID PLASTIC 0 90.NONE 0 ER(Specify): 99.OTHER 461.1. FILL COMPONENTS INSTALLED R 1.SPILL BUCKET R 3.STRIKER PLA77IBOTT'OM PROTECTOR R 4.CONTAINMENT SUMP 45Isc VII. UNDER DISPENSER CONTAINMENT(UDC) CONSTRUCTION TYPE _ _ 0 L SINGLE WALL _R 2.DOUBLE WALL 0 3.,NO DISPENSERS (] 90,NONE CONSTRUCTION MATERIAL 0 1.STEEL R 4.FIBERGLASS 0 10.RIGID PLASTIC 0 99.OTHER(Specify) a6sk VIII. CORROSION PROTECTION STEEL COMPONENT PROTECTION ❑ 2.SACRIFICIAL ANODE(S) ❑ 4.IMPRESSED CURRENT R 6.ISOLATION 449. 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 requirements. APPLICANT SIGNATURE DATE 470 APPLICANT NAME(lana) SYED K. AHMED 471 - APPLICANT TITLE Vice President 7