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09/25/2009 13:13 2094749151 HAMMER I5 ARCO PAGE 06116 • UNIFIED PROGRAM CONSOLIDATED FORM [I" �f�(p� �2, tTNDERGRO'UND STORAGE TANK 1 l OPERATING PERMIT APPLICATION-TANK INFORMATION (One form por UST) TYPE OF ACTION (Check one item only. For aUST'closure or removal,cgrViete only this section and Sections 1,IL 117,IV,and.l,X'below) 430• Q ( NEW PERMIT ❑ 3,RENEWAL PERMIT ® S.CHANGE OF INFORMATION ❑ 6.TEMPORARY UST CLOSURE ❑ 7.UST PERMANENT CLOSURE.ON SITE 8.UST REMOVAL DATE UST PERMANENTLY CLOSED: 4300. 1 DA'rb bMSTING UST DISCOVERED: 43ob. FACILITY ID#(eALM Use Oafy) I I Sil -7 BUSINESS NAME(Sarre as F aciltty Name or D.RA-•Dohcg Business FIs) 3. Hammer/1-5 Arco 104' BUSINESS SITE.ADDRESS 103 CITY 3250 W. Hammer Lane Stockton u. TANK ID# 432 TANK MANUFACTURER 435. T711... CONFIGURATION:THIS TANK IS 434• �� L2:2_ / c ® STAND-ALONE TANK Complete me iW�b Owens Corning ❑ NF,TN A CQMPARTMENTED UNIT 0-17 meea.a the-OIL DATE UST SYSTEM INSTALLED 435. TANK CAPACITY IN GALLONS 436. NUMBER OF COMPARTMENTS IN THE UNIT 437. 1985 1 12,000 1 NIMEMEM TANK USE ® Ia.M0TOR VEHICLE FUEL.NG ❑ Tb.MAR)NA,FUBI.ING ❑ lc.AVIATION FEnE1LING a39, ❑ 3.CHEMICAL PRODUCT STORAGE ❑ 4.HAZARDOUS WA.STB(Incledes Used oil) ❑ S.EMERGENCY GENERATOR FUEL[HSC§25281.5(c)] ❑ 6.01 GMgERATOR FUEL ❑ 95,UNKNOWN . - ❑99.OTI) ( ): --- -� ^---- 0 1b.PREMLUM UNLEADED CONTENTS PETROLEUM ❑ la.REGULAR UNLEADED ❑ Ic.MIDGRADE UNLEAUIyD r 440. ❑ 3.DIESEL ❑ 5.JET r vIlL 0, 6.AVIATION GAS ❑ S.PETROLEUM OLFND FUEL ❑ 9.0�IIER PETROLEUM SSPecifv); 4�' _ -- -NON-kETRO[EUM;O 7.USED OIL T W.ETHANOL-�� E] 11.01SER NON-PETROLEUM �fyS : ' ' lr I jgf!i TYPE OF TANK_ __ ❑ 1.51NOLE WALL 2.110UAL1:WAIL El95.UNKNOWN ___ 443' 444. PRIMARY CONTAINMENT TM ❑ 1.STEEL ® I.FIBERGT.ASS ❑ 6.INTERNAL BLADDER _ ❑ I.STEEL+_INTERNAL LINING ❑ 93.UNKNOWN ❑ 99. d44a' S15CONDARY CONTAINMENT 131.STEEL � M 3.YMERGLASS [36.)rXTERIOR MIZORANE LMR ❑ I.JACKETED 445 ❑ 90.NONE ❑ 95.UNKNOWN ❑99:OI]HlPxt„ (9pac�fy): 4a5a OVERFILL PRE�TTON T [11.AUDIBLE do VISUAL ALARMS ❑ 2.BALL FLOAT 0 3.FILL TUBE SHUT-OFF'VALvb 452." 4.TANK MEETS RE UIRE&tENTS FOR b(MON FROM OVFAFILL PREVENTION E UIFMENT i goill GC STRITICTIOW _ ❑ 1.SINGLE WALT. 2.DOUBLE WALL 13 99.OTSM _ __ 400' SYSTEM TYPE ® 1•_ U _--_0 2.GRA VITT( ❑ 3.CONVENTIONAL,SUCTT0N ❑ 4 TSAFE SUCTION{Z3 CQt�263B(aX3)3 433. PRIMARY CONTAINN>ENT 0 1.STEEL 0 4.FIBERGLASS ❑ S.FLEXIBLE [1 10.RIGID PLASTIC 444 ❑ 90.NONE ❑ 95.UNKNOWN Cl 99,OTHER(Specefy); 46aa. -SECONDARY CONTAINMENT 1:11.STEEL 0 4.FIBERGLASS ❑ 8.RT T+xTRT] Ll 10.RIGID PLASTIC 4 64.❑ 90.NONE ❑ 95.UNKNOWN ❑ 99.OTHER _ 464G PIPINGPPURBINE CONTAINMENT SUMP TYPE STNGT.E WALL 0 2.DOUBLE WALL ❑ 90.NONE 464d• VENT PRIMARY CONTAII�IMENT D 1.STE'EI._t9 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): VENT SECONDARY CONTAINMENT ❑ 1.STEEL ❑ 4.FIBERGLASS ❑ 10.RIGID PLASTIC 0 90.NONE ❑ 99.OTHER(Specify): 40(j, VR PRIMARY CON'T'AINMENT 0 1. 4.FIBERGLASS ❑ 10.RIGID PLASTIC ❑ 90.NONE ❑ 99.OTHER(Specify): Z. VR SECONDARY_CONTAINMENT ❑ 1.sTm. ❑ d.FMT�RRCI.ASS C1 10.RIGID PLASTIC 0 90.NONE 1199.0THER(b wify): VENT PIPING TRANSITION SUMP TYPE ❑ 1.SINGLE WALL Q 2 DOUBLE WALL _M 90.NOIR RISER PRIMARY CONTAINMENT 0 1.STEEL ❑ 4.FIBERGLASS ❑ I0.RIGID PLASTIC ❑ 90.NONE ❑ 99,OTHRt(Specify): 4441. _ 464IT. RISER SECONDARY CONTAINMENT ❑ 1.STEL ❑ 4.FIBERGLASS ❑ )o.1t)[31u PLASTIC IN 90.NONE EI 99.0 1�R(Spocity): 4 FILL COMPONENTS WSTAII.ED 1.SPILL BUG►cT7 0 3.STRIICER PLASE/130TTOI�IPROTECT0 0 4.CONIAIT=suw45Ta cc. CONSTRUCTION TYPE 0 I.SIl�TGLE wAL L ❑ 2.DOUBLE WALL ❑ 3.NO DISPENSERS '6S ❑ 10.RIGID PLAST[G ❑ 99.OTHER(Spwify) STEEL COMPUN6N I PROTlrC I ION ❑ 2. ACRIFICIAL AAIOD 5 4,BORESSED CURRENT 6.ISOLATION 448. CERTIFICATION:I certify that this UST system is compatible with the humdow substauce stored sad that the information provided Wenih is tragi, accurate and is A eomVm with legal requirements. APPLICANT SIGNATUREM1i 7 �� - DATE 9/21i/2009 4�0. APPLICANT NA (print) Wes y Parkinson 471' 1 APPLICANT T WE Ovmer 472. E , UPCF USI-0Itev.(12/2007)-V2 www.unidocs.org