Laserfiche WebLink
1.001 <br /> STATE ID NUMBER 00000003443001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> 01 NEW PERMIT ( ] 05 RENEWED PERMIT ( ) 07, TANK CLOSED ( ) 09 DELETE FROM FILE lHO FEE) <br /> 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> R. E. DEGNAVEL ( ) 01 FED ( ) 02 STATE f ) 03 LOCAL <br /> STREET ADDRESS <br /> Cl-TY STATC 2IP <br /> P. 0. BOX 1376 LA MESA CA 920410210 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> CARNIEGIE AUTO/TRUCK PLAZA _` <br /> STREET ADDRESS NEAREST CROSS�STREET <br /> %668-4. CORRAL HOLLOW RD <br /> CITY COUNTY IF <br /> TRACY SAN JOAQUIN 95376 <br /> MAILING ADDRESS CITYSTATE IIP <br /> 3600--S. CORRAL HOLLOW RD TRACY CA 95376 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-836-3805 (X) 01 GASOLINE STATION ( ) 02 OTHER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 8 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> 209-836-3805 <br /> wK <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( 1 04 OTHER: CONTAINER NUMBER 1 <br /> B. MANUFACTURER (IF APPROPRIATE): . YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 12000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES)= <br /> (X1 01 UNLEADED ( ) 02 REGULAR ( 1 03 PREMIUM ( ) 04 DIESEL ( ) 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( ) INCHES ( I CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( 02 NON-VAULTED (*t 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( 1 02 SINGLE WALLED f ) 03 LINED <br /> D. (X) 01 CARBON STEEL f ) 02 STAINLESS STEEL ( 103 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE 1 1 05 CONCRETE <br /> ( ) 06 ALUMINUM f ) 07 STEEL CLAD f ) 08 BRONZE f 1 09 COMPOSITE ( ] 10 NON-METALLIC <br /> l 1 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />