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IFIED PROGRAM CONSOLIDATED FORM I TANK: TA0508396 PR#: PRO505151 UNDERGROUND STORAGE TANKS - TAFAC#: FA0007815 1 Zl f)3 (two pages per tank) Page 2 of 7 TYPE OF ACTION ❑ I NEW SITE PERMIT ❑ 4 A%1[NDFD PLRf.1I l ❑ 5('HANW OF INFORMATION ❑ 6TEMPORARYSITE CLOSURE (CMck only iu`n ony) ❑ 7 PERMANENTLY CLOSED ON SITE ❑ 3RENEWAL PERMIT (Sptt4%rcoon-lm lural m<oNY) (9pa1%msm-fm burl meotay) ❑8TANK REMOVED 430 BUSINESS NAME(smnv FACILITY NAME or DBA-Dome Bmlrcss Aa) GACILIfY ID: PR 4: I PONTES QUICKI-KLEEN CAR WASH* FA0007815 PR0505151 LOCATION WITHIN SITE(0;,i 0 707 E YOSEMITE AVE,MANTECA 431 PHONE 1.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings and landmarks shall be subrnitted W the local agency.) TANKIDN Tank N: 4 432 TANK MANUFACTURER 4y3 COMPARTMENTALIZED TANK ❑Yes []No 434 TA0508396 TIPSA Ir^vm•,wttPmnon<we<(a.h�., DATESTSTALLED(YEAR/MO) 435 7ANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS m7 10 000 ADDITIONAL DESCRIPTION(For 1.1 mcool,) 439 II.TANK CONTENTS TANK USE 439 PETROLEUM TYPE aw ® I.MOTOR VEHICLE FUEL ® Ia.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL 0f maekMepnglae Pewlavn Type) ❑ Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ lc MIDGRADE UNLEADED ❑ 4.GASOHOL ❑ 99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(aoa Huawm Mammals Imrntprypage) 641 CAS#(bwn xaeatdom Naaiato Immm page) 642 ❑4.HAZARDOUS WASTE (tnc�Usodol) ❑ 95.UNKNOWN 111.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (CM1xk one iter ony) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN ® 2.DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT ❑99.OTHER TANK MATERIAL-primary tank ❑ 1.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN a4 (C kma imooly) ❑ 2.STAINLESS STEEL ❑ STEEL CLAD WNIBERGLASS ❑ a.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(1") ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ I.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 44s (Chmkamitanooly) ❑ 2.STAINLESS STEEL ❑ 4.STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑ 99.OTHER ❑ 5.CONCRETE TANKINTERIORLINING ❑ LRUBBERLINED ❑ 3.EPDXY LINING ❑ 5.GLASS LINING E]95.UNKNOWN 446 DATE INSTALLED a47 OR COATING (C kwrdmmly) E] 2ALKYD LINING C]4PHENOLIC LINING ❑ 6UNLMED ❑ 99.OTHER (For mnl manly) OTHER CORROSION ❑ I MANUFACTURING CATHODIC ❑3 FIBERGLASS REINFORCED PLASTIC ❑ 95UNKNOWN 4W DATE INSTALLED H9 PROTECTION IF APPLICABLE PROTECTION ❑41MPRESSED CURRENT E]99OTHER (CMckar tern O°ly) E]2SACRIFICIAL ANODE (Porlpol ac my) SPILL AND OVERFILL YEARINSTALLE450 TYPE(Jocalmconly) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (C6¢k ag dm spy) ❑ 1 SPILL CONTAINMENT ❑ 1 ALARM ❑ 3 FILL TUBE SHUT OFF VAL` ❑ 2 DROP TUBE ❑ 2 BALL ❑ 4 EXEMPT ❑ 3STRIKER PLATE FLOAT IV.TANK LEAK DETECTION(A moriptim ofdkaooionngpo® osl.0 x sobtmnW to d Ioml IF SINGLE WALL TANK(C6ak all mot appy) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (C6ak one 1rn only) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑3 CONTINUOUS ATG ❑ 7 GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ STANK TESTING ❑3 MANUAL MONITORING (SIR)BIENNDILTANKTESTING ❑ 99 OTHER V.TANK CLOSURE INFORMATION)PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 459 TANK FILLED WITH INERT MATERIAL? 457 2/2/1998 0.00 gallons ❑Yes ❑No UPCF(12/99 revised)