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FIED PROGRAM CONSOLIDATED FORM Ib D3 N : TA 19 PR0238405 984 UNDERGROUND STORAGE TANKS - TANK PA 1 1 / 1 '>li FAC#: FAOOOI393 1 a' 0 U (two pages per lank) TYPE OF ACTION ❑ 1 NEW SITE PERMIT ❑4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATIONPage 6 of9 ❑ 6 TEMPORARY SITE CLOSURE (Cbck way it=only) ❑ ?PERMANENTLY CLOSED ON SITE ❑ 3 RENEWAL PERMIT ❑8TANK REMOVED 430 BUSINESS NAME(S.u FACILITY NAME w DBA-Dai,6mhs_ce As) FACILITY ID: PR d: 1 MANTECA LIQUOR&FOOD ' FA0001393 PR0231984 LOCATION WITHIN SITE(oplimu0 890 N MAIN ST,MANTECA 431 PHONE I.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANK ID# Tank#: 5 433 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ❑Yes N. 434 TA0198405 Imm•,waplae wepage fo.wan wmpammmi. DATE PISTAI.LED(YEAR/MO) 435 TANK CAPACITY M GALLONS 436 NUMBER OF COMPARTMENTS 437 12,000 ADDITIONAL DESCRIPTION(Fmlom moanty) 438 H.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ® L MOTOR VEHICLE FUEL ® I.REGULAR UNLEADED ❑ 2.LEADED ❑ 5.JET FUEL pfmnkcdwmpinc Pcto,I=o Type) ❑ Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑ 6.AVIATION FUEL ❑2.NON-FUEL PETROLEUM ❑ Ic.MIDGRADE UNLEADED ❑4.GASOHOL ❑ 99.OTHER ❑3.CHEMICAL PRODUCT COMMON NAME(9om H.mtdom mok .E lwway page) 441 CAS#(6om Hnardmv m.00 s.umwtaty page) E]4.HAZARDOUS WASTE oaf porus Uset oil) ❑ 95.UNKNOWN III.TANK CONSTRUCTION TYPE OF TANK ❑ 1.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑ 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Chwk wicitwi Doty) EXTERIOR MEMBRANE LINER El 95.UNKNOWN ® 2.DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT ❑ 99.OTHER TANK MATERIAL-primary tank ❑ I.BARE STEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 444 (Check om iron only) ❑2.STAINLESS STEEL ❑ STEEL CLADWNIBERGLASS ❑ 8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ I.BARE STEEL ❑ 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 (Chwk on<imm only) ❑ 2.STAINLESS STEEL ❑ 4.STEEL CLAD W/FIBERGLASS ❑ 8.FRP COMPTIBLE W/100%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 (C1 one itch only) ❑ 2 ALKYD LINING ❑4 PHENOLIC LINING ❑ 6 UNLINED ❑".OTHER (Forlaml uu Duly) OTHERCORROSION ❑ 1 MANUFACTURING CATHODIC ❑ 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN 448 DATE INSTALLED a9 PROTECTION IF APPLICABLE PROTECTION (Chwk one ins only) ❑4 IMPRESSED CURRENT El 99 OTHER F1 2 SACRIFICIAL ANODE (Pon Iwl me onty) SPILL AND OVERFILL YEAR INSTALLE450 TYPE(1=11 only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Cnnxall wt apply) ® 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 ammipdw of momtorina psogmm scan eesahmitmd m do loot vgercy.) IF SINGLE WALL TANK(Chwk all dent 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 ❑ 1 VISUAL(EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING(MTG) (C oxttcnonly) ❑ 2AUTOMATIC TANK GAUGING(ATG) ❑ 6VADOSE ZONE ❑ 1 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 (SIR)BIENNIAL TANK TESTING ❑ 99 OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 ❑Yes ❑No UPCF(12/99 revised)