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4 HIED PROGRAM CONSOLIDATED FORM TANK: TA0504862 <br /> PR#: PR0231173 <br /> UNDERGROUND STORAGE TANKS - TANK PAGE 1 FAC#: FA0006423 <br /> (two pages per tank) <br /> Page 2 of <br /> TYPE OF ACTION ❑ 1 NEW SITE PERMIT ❑4 AMENDED PERMIT 5 CHANGE OF FORR1 ON ❑ 6 TEMPORARY SITE CLOSURE <br /> (Ca.rkwdyitc,nwly) ❑ 7 PERMANENTLY CLOSED ON SITE <br /> ❑ STANK REMOVED 430 <br /> ❑ 3RENEWAL PERMIT <br /> BUSINESS NAME(S.�w FACILIYN"E a DBA-DoingBwivm.A.) FACILITY ID: PR#: t <br /> on l I eD C AS; 3 FA0006423 PR0231173 <br /> LOCATION WITHIN SITE(00-1) 3440 E MAIN ST,STOCKTON �oA / q 431 <br /> PHONE - .36' q r <br /> I.TANK DESCRIPTION(A scaled plot plan with the location R Ne UST system including buildings and landmarks shall be submitted m the local agency.) <br /> TANK II#f Tank#: 4 431 TANKMANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yes No 434 <br /> TA0504862 TRUSCO B-re'.oGml<m on<we.ror od,oMgw�m.. <br /> DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 <br /> 10/21/1993 10,0 0 <br /> ADDITIONAL DESCRIFTIUN(Formes wcwdy) 433 <br /> H.TANK CONTENTS <br /> TANKUSE 439 PETROLEUM TYPE 440 <br /> ® I.MOTOR VEHICLE FUEL E] I..REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FURL <br /> (tfnvk<d.wiplN<Peaokwn Typc) ® Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑ 6.AVIATION FUEL <br /> ❑ 2.NON-FUEL PETROLEUM ❑ Ic MIDGRADEUNLEADED ❑ 4.GASOHOL ❑ 99.07THER <br /> ❑ 3.CHEMICAL PRODUCT COMMON NAME(f Hunrdow Metviel.Nvmtaypeg<) 441 CAS#(tmn HamMow M.�maL' v ur.<+nwy page) a2 <br /> ❑ 4.HAZARDOUS WASTE <br /> (m.lww u3.dai> <br /> ❑ 95.UNKNOWN <br /> ID.TANK CONSTRUCTION <br /> TYPE OF TANK ❑ 1.SINGLE WALL ❑ gXlINNGLE WALL WITH MEMBRANE LINER ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM M3 <br /> (Chale aw iwaaiJy) ❑95.UNKNOWN <br /> ® 2.DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT ❑ 99.OTHER <br /> TANK MATERIAL-primary tank ❑ 1.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 444 <br /> (Cne .inaowy) ❑ 2.STAINLESS STEEL ® STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL <br /> REINFORCED PLASTIC(FRP) ❑ 99.OTHER <br /> TANK MATERIAL-secondary tank ❑ 1.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 <br /> (L7a .ftananiy) ❑2.STAINLESS STEEL BERGLASS ❑ 8.FEPCOMPTIBLEW/100%METHANOL <br /> FRP) ❑ 10.COATED STEEL ❑ 99.OTHER <br /> ❑ 5.CONCRETE <br /> 447 <br /> TANK INTERIOR LINING E] I. IN <br /> RUBBER LED F13.EPDXY LINING E] 5.GLASS LIVING ❑95.UNKNOWN 446 DATE INSTALLED <br /> OR COATING ❑ 99.OTHER <br /> (Chale m.itana0y) ❑ 2ALKYD LINING ❑ 4PHENOLIC LINING ® 6UNLINED (F<rlowt w.ardy) <br /> 449 <br /> OTHER CORROSION ❑ I MANUFACTURING CATHODIC ® 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN MB DATEINSTALLED <br /> PROTECTION IF APPLICABLE PROTECTION ❑4 IMPRESSED CURRENT ❑ "OTHER <br /> (CM#mcitanonly) F-12 SACRIFICIAL ANODE (Pmlaml w.only) <br /> ILL YEAR FNSTALLL450 TYPE(ladw.o*) 5 OVERFILL PROTECTION EQUIPMENT RINSTALLED <br /> SPILL AND OVERF <br /> l I ILLAONTA LAMENT 1,993.00 ❑ I ALARM LTUBE SHUT OF <br /> (Oh kalldutwply) -/ JBE ❑ 2BALL ❑ 4EXEMPT <br /> R❑�3-STRIKER PLATE FLOAT <br /> [V.TANK LEAK DETECTION(w de4viptondt � 3tw16.sab�ned to gieloul agacy.) <br /> 4 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 <br /> IF4 ly (Chakm.iwnonly) <br /> i V SU ( XP EDP ION O Y) NGRONED <br /> GAUG G(M <br /> ❑ I AL(SINGLE WALL IN VAULT ONLY) <br /> '2 U I TIC NK GING G) E <br /> UOUS TO E MUOUS INTERSTITIAL MONITORING <br /> T TI L RY CO CI T1 G ❑3 MANUAL MONITORING <br /> i/ (SIR)BI LTANKT T ❑ 99 OTHER <br /> V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE <br /> ESTIMATED DATE LAST USED(YR/MO/DAY) <br /> 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIA.? 457 <br /> ❑Yes ❑ No <br /> UPCF(12/99 revised) <br />