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San Joaquin *ley Unified Air Pollution Atrol District <br />Supplemental Application Form <br />GASOLINE DISPENSING <br />This form must be accompanied by a completed Application for Authority to Construct and Permit to <br />Permit to be issued to: <br />ARCO # 6347 <br />Location where the equipment will be operated: <br />2430 Joe Pombo Pkwy, Tracy, CA <br />Current Permit to Operate number (if applicable): <br />Instructions <br />Complete a separate form for each tank and dispensing system which has a different type of Phase I or <br />Phase II vapor recovery system with as much information as possible. <br />form. <br />2 Attach a copy of the site plan showing underground fuel and vapor lines and location of dispenser islands. You <br />may submit the drawings in electronic format. <br />Note: Information on Vapor Recovery Executive Orders is available online at: www.arb.ca.-gov/vapor/vapor.htm <br />Gasoline Storage Tanks and Nozzles <br />Quantity of Type of Tanks Capacity in Gallons Type and Grade <br />Tanks (Check One for Each Tank) (Indicate if Split Tank) of Fuel <br />4 ✓ Underground ❑ Aboveground* unknown Unleaded gas <br />❑ Underground ❑ Aboveground* <br />❑ Underground ❑ Aboveground* , i; <br />if i ❑ Underground ❑ Aboveground* <br />�! Total Number of Gasoline Dispensers: ! 6 <br />if i (Maximum number of vehicles which can be fueled at one time, !� <br />Total Number of Gasoline Fueling Points: s 12 normally two vehicles per dispenser) <br />" Total Number of Gasoline Dispensing Nozzles: ; 12 (Do not include Diesel) <br />„ .. <br />�+ # Grades of Gasoline Dispensed per Nozzle: 3 H <br />if <br />Total Number of Vapor Recovery instruction Signs: 12 (Should be clearly readable from every fueling point) H <br />Maximum Facility Gasoline Throughput No change Gallons per Month No change <br />„ <br />Facility Type ✓ Retail ❑ Non -Retail <br />*For Aboveground Tanks (includes tanks in underground vaults) <br />Manufacturer: <br />CARB Executive Order Number: <br />Gallons per year <br />i <br />01 cn cr; t nnrTrnrr rc nnr oc111:pcc cines -11)m1) <br />