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Aak NIFIED PROGRAM CONSOLIDATED FORT - TANKS UNDERGROUND STORAGE TANKS -TANK PA fel D �nk) Lj Page 5 of 7 TYPE OF ACTION ❑ 1 NEW SITE PERMIT ❑ 4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑6 TEMPORARY SITE CLOSURE (Check only item only) ❑ 7 PERMANENTLY CLOSED ON SITE (Specify reason-fm local use Daly') (specify reason-for kcal use only) 430 ❑3 RENEWAL PERMIT STANK REMOVED BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Burow As) FACILITY ID: 1 STOCKTON USD-CORP YARD 3 FA0004016 ( 5 Q �p ?j LOCATION WITHIN SITE(;5;donal) asl 032-- El E� 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.) TAN K ID# a32 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK E]yes No 434 11.00 MODERN WELDING a•Yes%complete one page for each cmttparnnent. DATE INSTALLED(YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 15,000 ADDITIONAL DESCRIPTION(For local use only) 438 II.TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ® I.MOTOR VEHICLE FUEL ® la.REGULAR UNLEADED ❑2.LEADED ❑ 5.JET FUEL (Ifmmked complete petroleum 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(rmm Hazardous Materials Inventory page) 441 CAS#(from Hazardous Materials Inventory page) 441 ❑4.HAZARDOUS WASTE (Inclmaes Used oil) REGULAR ❑ 95.UNKNOWN 111.TANK CONSTRUCTION TYPE OF TANK ❑ I.SINGLE WALL ❑ 3.SINGLE WALL WITH ❑5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Click one item only) EXTERIOR MEMBRANE LINER El95.UNKNOWN ❑ 2.DOUBLE WALL ❑4.SINGLE WALL IN VAULT ❑99.OTHER TANK MATERIAL-primary tank ® 1.BARESTEEL ❑ FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 144 (Check one item only) ❑ 2.STAINLESS STEEL ❑STEEL CLAD W/FIBERGLASS ❑ S.FRP COMPTIBLE W/l00%METHANOL REINFORCED PLASTIC(FRP) ❑99.OTHER TANK MATERIAL-secondary tank ❑ I.BARE STEEL 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN 445 (Check one item only) ❑ 2.STAINLESS STEEL 4.STEEL CLAD W/FIBERGLASS S.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 10.COATED STEEL ❑99.OTHER ❑ 5.CONCRETE 447 TANK INTERIOR LINING ❑ 1.RUBBER LINED ❑ 3.EPDXY LINING ❑ 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED OR COATING ❑ 99.OTHER (Check one item only) ❑ 2 ALKYD LINING ❑4 PHENOLIC LINING ®6 UNLINED (For local use only) 449 OTHER CORROSION ❑ 1 MANUFACTURING CATHODIC ®3 FIBERGLASS REINFORCED PLASTIC ❑95 UNKNOWN 448 DATE INSTALLED PROTECTION IF APPLICABLE PROTECTION ❑4 IMPRESSED CURRENT ❑99 OTHER (Check one item only) ❑2 SACRIFICIAL ANODE (For 1=1 use only) SPILL AND OVERFILL YEARINSTALLED 450 TYPE(Ioaluse only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all that apply) SPILL CONTAINMENT 1996 ❑ l ALARM V3 FILL TUBE SHUT OFF VALVE 2 DROP TUBE E] 2 BALL FLOAT ❑4 EXEMPT 1 t3 STRIKER PLATE IV.TANK LEAK DETECTION(A description or the monitoring program shall be submitted to the local agency.) IF SINGLE WALL TANK(Check all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 5 MANUAL TANK GAUGING(MTG) (Check one item only) ❑ l VISUAL(EXPOSED PORTION ONLY) ❑ ❑ I VISUAL(SINGLE WALL IN VAULT ONLY) ❑2 AUTOMATIC TANK GAUGING(ATG) ❑6 VADOSE ZONE �.�t ❑ 3 CONTINUOUS ATG E] 7 GROUNDWATER /I XI 2 CONTINUOUS INTERSTITIAL MONITORING ❑4 STATISTICAL INVENTORY RECONCILIATION ❑ S TANK TESTING �❑3 MANUAL MONITORING (SIR)BIENNIAL TANK TESTING ❑ 99 OTHER V.TANK CLOSURE INFORtrIATION/PERTNIANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED(YRIMO/DAY) a55 ESTIMATED QUANTITY OF SUBSTANCE REMAINING a56 TANK FILLED WITH INERT MATERIAL? 457 gallons ❑Yes ❑No UPCF(12/99 revised)