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IIFIED PROGRAM CONSOLIDATED FO'less, ad UNDERGROUND STORAGE TANKS - TANK PAGE /` TANKS (two pages per tank) Page_of TYPE OF ACTION ❑1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ® 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE (Check one item only) ❑ 7 PERMANENTLY CLOSED ON SITE ❑ 3 RENEWAL PERMIT (Specify reason-for Marl wanly) (specilymeon-forlocalwonly) ❑ 8 TANKREMOVED 430 BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) FACILITY ID: 1 Tesoro West Coast Company,LLC USA,CC#SS750 b LOCATION WITHIN SITE(Optional) 431 I.TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local a en TANK ID# 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK Yes No 434 STIP Ill complete one page for each carpaMerr. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 1990 10,000 ADDITIONAL DESCRIPTION(For local use only) 438 It.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ®1. MOTOR VEHICLE FUEL 01a. REGULAR UNLEADED ❑2. LEADED ❑5. JET FUEL y marked conglete Petroleum Type) ❑1b. PREMIUM UNLEADED ❑3. DIESEL ❑6. AVIATION FUEL Cl 2. NON-FUEL PETROLEUM ❑ 1c. MIDGRADE UNLEADED ❑4. GASOHOL ❑99.OTHER ❑3. CHEMICAL PRODUCT COMMON NAME (from Haiardous Materials Inventory page) 441 CAS#((ran Heusi Materiels inventory page) 442 ❑4. HAZARDOUS WASTE UNLEADED FUEL 800-61-9 (incudes Used Oil) ❑95.UNKNOWN III. TANK CONSTRUCTION TYPE OF TANK ❑ 1. SINGLE WALL ❑3.SINGLE WALL WITH ❑5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one Mem only) EXTERIOR MEMBRANE LINER ❑95. UNKNOWN ®2. DOUBLE WALL ❑4. SINGLE WALL IN VAULT ❑99. OTHER TANK MATERIAL-primary tank a 1. BARE STEEL 0 3. FIBERGLASS/PLASTIC 0 5. CONCRETE 95. UNKNOWN 444 (Check oro item only) ❑2. STAINLESS STEEL [14. STEEL CLAD W/FIBERGLASS ❑8. FRP COMPATIBLE W/ ❑99.OTHER REINFORCED PLASTIC(FRP) 100%METHANOL TANK MATERIAL-secaMaytrk 1. BARE STEEL 3. FIBERGLASS/PLASTIC 5. CONCRETE 95. UNKNOWN 443 (Check aro item only) ❑2. STAINLESS STEEL ®4.STEEL CUD W/FIBERGLASS ❑8. FRP COMPATIBLE ❑99.OTHER REINFORCED PLASTIC(FRP) W/100%METHANOL ❑5. CONCRETE ❑10.COATED STEEL TANK INTERIOR UNING ❑1.RUBBER LINED ❑3.EPDXY LINING ❑5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED 447 OR COATING ❑2 ALKYD LINING ❑4 PHENOLIC LINING ®6 UNLINED ❑99 OTHER (Check ansa Mem only) (For local use only) OTHER CORROSION ❑1 MANUFACTURED CATHODIC❑3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ❑4 IMPRESSED CURRENT ❑99 OTHER (Check oro Mem only) V2SACRIFICIAL ANODE (For locales only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE(local Use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 n wars ®1 SPILL CONTAINMENT 1990 ®1 ALARM UNK ❑3 FILL TUBE SHAT OFF VALVE ®2 DROP TUBE 1990 ®2 BALL FLOAT LINK ❑4 EXEMPT ®3 STRIKER PLATE 1990 IV.TANK LEAK DETECTION(A description of the monitoring program shall Its submitted to the local agency.) IF SINGLE WALL TANK(Check all Ihatepply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Checkane item only) ❑1 VISUAL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING(MTG) ❑1 VISUAL(SINGLE WALL IN VAULT ONLY) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE ®2 CONTINUOUS INTERSTITIAL MONITORING ❑3 CONTINUOUS ATG ❑7 GROUNDWATER ❑3 MANUAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑8 TANK TESTING +(SIR) BIENNIAL TANK TESTING ❑99 OTHER IV.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YR/MO/DAV) 455 ESTIMATED QUANTITY OF SUBSTANCE 455 TANK FILLED WITH INERT MATERIAL? 457 REMAINING gallons ❑Yes ❑ No UPCF(12/99 revised) Formeriv SWRCB Form B