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0--a.If-02 FIED PROGRAM CONSOLIDATED FORM TANK: TA0505759 PRN: 0 UNDERGROUND STORAGE TANKS -TANK PAGE 1 FAC N: FA00037143I4 (two pages per tank) TYPE OF ACTION ❑ 1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE Page 4.f7 (Chock Doty itom Doty) ❑ 7 PERMANENTLY CLOSED ON SITE ❑3 RENEWAL PERMIT ❑8TANK REMOVED 430 BUSINESS NAME(samem FACR1TYNAMemDBA-Doing emmms An FACILITYID: PR#: t CHEVRON USA INC#91452" 3 FA0003714 PR0231665 LOCATION WITHIN SITE(optimu0 334 E MARY ST,RIPON 431 PHONE L TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted W the local agency.) TANK IDN Tank#: 7 4;2 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑yes ❑No 434 TA0505759 XERXE$ If^Y®",mmpleuampagc fm each ea�rya�Mmt DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY INGALLONS 416 NUMBER OF COMPARTMENTS 417 8/1/1995 12,000 ADDITIONAL DESCRIPTION(Forlmd me only) 438 II.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ® 1.MOTOR VEHICLE FUEL ® la.REGULAR UNLEADED ❑ 2.LEADED ❑5.JET FUEL nr.rhWcumplote Fme,I nType) ® Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑ 6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ Ip MIDGRADE UNLEADED ❑4.GASOHOL ❑ 99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(nom Havrdom Materials lmmm,papc) 441 CAS#(nom H--sow Materials Inventory page) 443 ❑4.HAZARDOUS WASTE I q1 oneludm Usedoth BOO�o- I -I - I ❑95.UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ❑ 3.SINGLE WALL WITH E] 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Click one iron only) EXTERIOR MEMBRANE LINER ❑ 95.UNKNOWN ® 2.DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT ❑ 99.OTHER TANK MATERIAL-primary lank ❑ 1.BARE STEEL M FIBERGLASS/PLASTIC ❑5.CONCRETE ❑ 95.UNKNOWN 444 (C omeimnonly) ❑2.STAINLESS STEEL ❑ STEEL CLAD W/FIBERGLASS ❑8.FRP COMPTIBLE W/IW%METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ I.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (Chmkomitanonly) ❑2.STAINLESS STEEL ❑4.STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W1100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑99.OTHER ❑ 5.CONCRETE TANK INTERIOR LINING ❑ 1.RUBBER LINED ❑ 3.EPDXY LININGS.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED (Chmk one iummly) ❑2 ALKYD LINING ❑4 PHENOLIC LINING ® 6 UNLINED ❑99.OTHER (Fmloml me only) OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC ® 3 FIBERGLASS REINFORCED PLASTIC449 PROTECTION IF APPLICABLE PROTECTION ❑ 95 UNKNOWN Me DATE INSTALLED (Chakomiirnmuy) ❑ 41MPRESSED CURRENT ❑ 99 OTHER ❑2 SACRIFICIAL ANODE (Fa tical meanty) SPILL AND OVERFILLpL�� YEAR INSTALLE450 TYPE(Imalmconly) 451 OVERFILL PROTECTION EQUIPMENT:YEA INSTALLED 452 N (Chall w t amly) Ka I SPILL CONTAINMENT 1,995.00 ElI ALAR Y` �1 ❑03FILL TUBE SHIT OFF VAL' 2DROP TUBE ❑ 2BALL ❑4EXEMPT ❑ 3 STRIKER PLATE FLOAT rV.TANK LEAK DETECTION(Ad criptbnofdmmmdwrinproarams IIt,tsunm Wer 0ckmlasnmy) IF SINGLE WALL TANK(Chcck all slut apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (C6eek o iummly) ❑ 2AUTOMATICTANKGAUGING(ATG) ❑ 6VADOSE ZONE ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑ 3 CONTINUOUS ATG ❑ 7 GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING ❑3 MANUAL MONITORING (SH)BIENNIA.TANK TESTING ❑ 99 OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 1 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL' 457 ❑Yes ❑ No UPCF(12/99 revised)