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tt4- <br />IFIED PROGRAM CONSOLIDATED FO t TANK: TA0425103 <br />PR #: PR0234251 <br />UNDERGROUND STORAGE TANKS - TANK 4A FAC #: FA0003508 <br />N t s per tank) <br />Page 2 of 5 <br />TYPE OF ACTION ❑ I NEW SITE PERMIT ❑ 4 AMENDED PERMIT 5 CHANGE OF INFORMATION ❑ 6 TEMPORARY SITE CLOSURE <br />(Check only item only) s, yy),,,a,� ' Rrg =i r� <br />❑ 7 PERMANENTLY CLOSED ON SITE <br />❑ 3 RENEWAL PERMIT S 9" ❑ 8 TANK REMOVED 430 <br />BUSINESS NAME (Same as FACB.ITY NAME or DBA - Doing Business As) <br />FACILITY ID: PR #: <br />1 <br />ACE TOMATO CO INC <br />3 <br />FA0003508 PR0234251 <br />LOCATION WITHIN SITE (Optional) 2771 E FRENCH CAMP RD, MANTECA 431 <br />PHONE <br />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.) <br />TANK ID# Tank #: 3 432 <br />TANK MANUFACTURER 433 <br />COMPARTMENTALIZED TANK ❑ Yes ❑ No 434 <br />TA0425103 <br />ARROW <br />If "Yes", cor pletc one page for each compartment. <br />DATE INSTALLED (YEAR/MO) 439 <br />TANK CAPACITY IN GALLONS 436 <br />NUMBER OF COMPARTMENTS 437 <br />9/1/1989 <br />6,000 <br />ADDITIONAL DESCRIPTION (For local use only) 438 <br />H. TANK CONTENTS <br />TANK USE 439 <br />PETROLEUM TYPE 440 <br />® 1. MOTOR VEHICLE FUEL <br />® I a. REGULAR UNLEADED ❑ 2. LEADED ❑ 5. JET FUEL <br />(If narked complete Petroleum Type) <br />❑ Ib. PREMIUM UNLEADED ❑ 3. DIESEL ❑ 6. AVIATION FUEL <br />❑ 2. NON-FUEL PETROLEUM <br />❑ Ic. MIDGRADE UNLEADED ❑ 4. GASOHOL ❑ 99. OTHER <br />❑ 3. CHEMICAL PRODUCT <br />COMMON NAMEfrom Hazardous Materials Invento c <br />( rypa8) 441 <br />from Hazardous Materials Invento a <br />CAS# ( ryPe B) 442 <br />❑ 4. HAZARDOUS WASTE <br />(Includes Used Oil) <br />❑ 95. UNKNOWN <br />M. TANK CONSTRUCTION <br />TYPE OF TANK ❑ L SINGLE WALL ❑ 3. SINGLE WALL WITH ❑ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 <br />(Check one item only) EXTERIOR MEMBRANE LINER ❑ 95. UNKNOWN <br />® 2. DOUBLE WALL ❑ 4. SINGLE WALL IN VAULT ❑ 99. OTHER <br />TANK MATERIAL - primary tank ® L BARE STEEL ❑ FIBERGLASS/ PLASTIC ❑ 5. CONCRETE ❑ 95. UNKNOWN 444 <br />(Check one item only) ❑ 2. STAINLESS STEEL ❑ STEEL CLAD W/FIBERGLASS ❑ 8. FRP COMPTIBLE W/ 100% METHANOL <br />REINFORCED PLASTIC (FRP) ❑ 99. OTHER <br />TANK MATERIAL - secondary tank ❑ 1. BARE STEEL ❑ 3. FIBERGLASS / PLASTIC ❑ 5. CONCRETE ❑ 95. UNKNOWN 445 <br />(Check one item only) ❑ 2. STAINLESS STEEL ® 4. STEEL CLAD W/FIBERGLASS ❑ 8. FRP COMPTIBLE W/100 % METHANOL <br />REINFORCED PLASTIC (FRP) ❑ 10. COATED STEEL ❑ 99. OTHER <br />❑ 5. CONCRETE <br />TANK INTERIOR LINING ❑ L RUBBER LINED ❑ 3. EPDXY LINING ❑ 5. GLASS LINING ❑ 95. UNKNOWN 446 DATE INSTALLED 447 <br />OR COATING <br />❑ 99. OTHER <br />(Check one item only) ❑ 2 ALKYD LINING ❑ 4 PHENOLIC LINING ® 6 UNLINED _ <br />(For local use only) <br />OTHER CORROSION ❑ i MANUFACTURING CATHODIC ❑ 3 FIBERGLASS REINFORCED PLASTIC ❑ 95 UNKNOWN 448 DATE INSTALLED 449 <br />PROTECTION IF APPLICABLE PROTECTION <br />❑ 4 IMPRESSED CURRENT ❑ 99 OTHER <br />(Check one item only) <br />❑ 2 SACRIFICIAL ANODE (For Iocai use only) <br />SPILL AND OVERFILL YEAR INSTALLE450 TYPE (local use only) 451 <br />OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 <br />(Check all that apply) ® I SPILL CONTAINMENT ".9.00,t00 - �j <br />�� <br />E]21'"'1 ALARM 3 FILL TUBE SHUT OFF VAL` -�.y- f <br />F4 <br />❑ 2 DROP TUBE <br />®2 BALL 1,989.00 EXEMPT <br />❑ 3 STRIKER PLATE <br />FLOAT <br />IV. TANK LEAK DETECTION (A description of the monitoring program shall be submitted to the lora[ agency.) <br />IF SINGLE WALL TANK (Check all that apply) 453 <br />IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 <br />❑ 1 VISUAL (EXPOSED PORTION ONLY) ❑ 5 MANUAL TANK GAUGING (MTG) <br />(Check one nem only) <br />❑ 2 AUTOMATIC TANK GAUGING (ATG) ❑ 6 VADOSE ZONE <br />❑ 1 VISUAL (SINGLE WALL IN VAULT ONLY) <br />❑ 3 CONTINUOUS ATG ❑ 7 GROUNDWATER <br />® 2 CONTINUOUS INTERSTITIAL MONITORING <br />❑ 4 STATISTICAL INVENTORY RECONCILIATION ❑ 8 TANK TESTING <br />❑ 3 MANUAL MONITORING <br />(SIR) BIENNIAL TANK TESTING ❑ 99 OTHER <br />V. TANK CLOSURE INFORMATION / PERMANENT CLOSURE IN PLACE <br />ESTIMATED DATE LAST USED (YR/MO/DAY) 455 <br />ESTIMATED QUANTITY OF SUBSTANCE REMAINING a56 <br />TANK FILLED WITH INERT MATERIAL? 457 <br />1 <br />❑ Yes ❑ No <br />UPCF (12/99 revised) <br />