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ink Description ik ID# nk 2 ik Manufacturer Tank Capacity In Gallons 5000 Date UST System Installed Tank Configuration One in a Compartmented Unit Date Existing UST Discovered Number of Compartments in the Unit 2 Date UST Permanently Closed Additional Description Tank Use and Contents Tank Use Tank Contents Motor Vehicle Fueling Premium Unleaded Other Petroleum Contents Otter Non -Petroleum Contents Tank Construction Type of Tank Double Wall Primary Containment Fiberglass Secondary Containment Fiberglass Overfill Protection Audible/Visual Alarms Fill Tube Shut -Off Valve Ball Float Exempt Product / Waste Piping Construction -- -- >iping Construction Primary Containment Secondary Containment Piping/Turbine Containment Sump Double -walled Fiberglass Fiberglass j Double -walled liping System Type pressure _ Vent, Vapor Recovery (VR) and Riser / FII Pipe Piping Construction Primary Containment Vapor Recovery Primary Containment Fiberglass Fiberglass Secondary Containment Vapor Recovery Secondary Containment Fiberglass Fiberglass Under Dispenser Containment (UDC) Construction Type Con Double -walled Fibe Applicant Certification Riser Pipe Primary Containment Fiberglass Riser Pipe Secondary Containment Fiberglass — Corrosion Protection struction Material Sacrificial Anode rglass Impressed Current Isolation Applicant Name Applicant Title Printed on 6/26/2013 2:12 PM Date Certified Vent Piping Transition Sumps Double -walled Fill Components Installed Yes Spill Bucket Striker Plate/Bottom Protector u AL California Environmental Reporting Underground Facility/Site SUPER CENTER MART* CERs ID 701 E CHARTER WAY 10180955 STOCKTON, CA 95206 Submittal Status Submitted on 6/26/2013 by Swaran Chouhan of SUPER CENTER MART* (STOCKTON, CA) Type of Action - Type of Action (UST Tank) ENVI R®N M EN New Permit Facility Information SUPER CENTER MART* 701 E CHARTER WAY STOCKTON, CA 95206 ink Description ik ID# nk 2 ik Manufacturer Tank Capacity In Gallons 5000 Date UST System Installed Tank Configuration One in a Compartmented Unit Date Existing UST Discovered Number of Compartments in the Unit 2 Date UST Permanently Closed Additional Description Tank Use and Contents Tank Use Tank Contents Motor Vehicle Fueling Premium Unleaded Other Petroleum Contents Otter Non -Petroleum Contents Tank Construction Type of Tank Double Wall Primary Containment Fiberglass Secondary Containment Fiberglass Overfill Protection Audible/Visual Alarms Fill Tube Shut -Off Valve Ball Float Exempt Product / Waste Piping Construction -- -- >iping Construction Primary Containment Secondary Containment Piping/Turbine Containment Sump Double -walled Fiberglass Fiberglass j Double -walled liping System Type pressure _ Vent, Vapor Recovery (VR) and Riser / FII Pipe Piping Construction Primary Containment Vapor Recovery Primary Containment Fiberglass Fiberglass Secondary Containment Vapor Recovery Secondary Containment Fiberglass Fiberglass Under Dispenser Containment (UDC) Construction Type Con Double -walled Fibe Applicant Certification Riser Pipe Primary Containment Fiberglass Riser Pipe Secondary Containment Fiberglass — Corrosion Protection struction Material Sacrificial Anode rglass Impressed Current Isolation Applicant Name Applicant Title Printed on 6/26/2013 2:12 PM Date Certified Vent Piping Transition Sumps Double -walled Fill Components Installed Yes Spill Bucket Striker Plate/Bottom Protector u AL