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zl 3lo ANK: TA0515519 FIED PROGRAM CONSOLIDATED FORM49 PR#: PRO515864 FAC#: FA0012355 UNDERGROUND STORAGE TANKS - TANK PAGE 1 (two pages per tank) Page 4 of 7 FBUSINESS TION 1 NEW SITE PERMIT ❑4 AMENDED PERMIT ❑ 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE 11,01101110 ❑ ;. ❑ 7 PERMANENTLY CLOSED ON SITE SPeeit)reBott= 'bcalreeauty) (St>ea> t firtkrag) ❑8TANKREMOVED 430 ❑ 3 RENEWAL PERMIT - l FACILITY ID: PR#: NAME(Same as FACILITY NAMEor DBA-Doing Business As) 3 FA0012355 PR0515864 GAS DEPOT#2 431 LOCATION WITHIN SITE(Optional) 1330 E YOSEMITE AVE,MANTECA PHONE I.TANK DESCRIPTION(A scaled plot plan with the location of the UST system including buildin OMPan MEkNTall be ALIZED T1ANKto the local agency.) TANK MANUFACTURER 433 ❑Yes ❑No 434 TANK ID# Tank#: 2 432 TA0515519 FLUID CONTAINMENT If"Yes complete one Page for each compartment. NUMBER OF COMPARTMENTS 437 DATE INSTALLED(YEAR/MOTANK CAPACITY IN GALLONS 436) 435 2 4/10/2000 12:00:00AM 10,000 438 ADDITIONAL DESCRIPTION(For local use only) 11.TANK CONTENTS 440 TANK USE 439 PETROLEUM TYPE 5.JET FUEL ® 1.MOTOR VEHICLE FUEL ❑ la.REGULAR UNLEADED ❑ 2.LEADED ❑ (If marked complete Petroleum TYPe) ® Ib.PREMIUM UNLEADED ❑ 3.DIESEL ❑6.AVIATION FUEL ❑ 2.NON-FUEL PETROLEUM ❑ I c.MIDGRADE UNLEADED E]4.GASOHOL E]99.OTHER ❑ 3.CHEMICAL PRODUCT COMMON NAME(Erre Hazardous Materials inventory page) 441 CA$#(from Hazardous Materials Inventory page) 442 ❑4.HAZARDOUS WASTE (Includes Used Oil) ❑ 95.UNKNOWN III.TANK CONSTRUCTION 1.SINGLE WALL ❑ 3.SINGLE WALL WITH [-] 5.SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 TYPE OF TANK ❑ EXTERIOR MEMBRANE LINER ❑95.UNKNOWN (Check one item only) ® 2.DOUBLE WALL ❑ 4.SINGLE WALL IN VAULT E] 99.OTHER 444 TANK MATERIAL-primal)tank ❑ I.BARE STEEL ® FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑95.UNKNOWN (Check one item only) ❑ 2.STAINLESS STEEL E] STEEL CLAD W/FIBERGLASS ❑8.FRP COMPTIBLE W/100%METHANOL REINFORCED PLASTIC(FRP) ❑ 99.OTHER TANK MATERIAL-secondary tank ❑ 1.BARE STEEL 3.FIBERGLASS/PLASTIC ❑ 5.CONCRETE ❑ 95.UNKNOWN 445 IBLE (Check one item only) ❑2.STAINLESS SEEL ❑REITEEL CLAD NFORCEDPLASTIC(FRP)SS ❑ 10. ATT DPSTEEL W/i ❑99.OTHER ❑ 5.CONCRETE 447 TANK INTERIOR LINING F1 1.RUBBER LINED ❑ 3.EPDXY LINING ® 5.GLASS LINING ❑95.UNKNOWN 446 DATE INSTALLED E] 99.OTHER (Check one item only) F12 ALKYD LINING ❑ 4 PHENOLIC LINING ❑ 6UNLINED (For local use OR COATING 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 (For local use only) (Check one item only) ❑ 2 SACRIFICIAL ANODE 452 YEAR INSTALLE450 TYPE(local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED F(C-k VERFILL ® 1 SPILL CONTAINMENT 2,000.00 1 ALARM 2,000.00 ®3 FILL TUBE SHUT OFF VAL`2,000.0 t apply) 4 EXEMPT X❑ 2 DROP TUBE 2,000.00 ❑ 2 BAIL FLOAT ❑X 3 STRIKER PLATE 2,000.00 IV.TANK LEAK DETECTION(A description of the monitoring program shall be submitted to the local agency') 454 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER ALL TANK(Check all that apply) (Check one item only)AL(EXPOSED PORTION ONLY) ❑5 MANUAL TANK GAUGING(MTG) ❑ 1 VISUAL(SINGLE WALL IN VAULT ONLY)OMATIC TANK GAUGING(ATG) ❑6 VAROSE ZONE TINUOUS ATG7 GROUNDWATER ®2 CONTINUOUS INTERSTITIAL MONITORING TISTICAL INVENTORY RECONCILIATION ❑8 TANK TESTING ❑3 MANUAL MONITORING (SIR)BIENNIAL TANK TESTING ❑99 OTHER V.TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE 456 TANK FILLED WITH�INERTTERIAL? 457ESTIMATED DATE LAST USED(YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING ❑No❑Ye UPCF(12/99 revised)