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• STATE ID NUMBER 00000041881001 1 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND S(ORBAGDE TAK <br /> LETS FROM FILE (NO FEEL <br /> O1 NEW PERMIT ( ) 05 RENEWED PERMIT <br /> C ( ) 07 TANK CLOSED <br /> 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> PUBLIC AGENCY ONLY <br /> NAME(COPPOPATION,IND:VIDVAL OR PUBLIC AGENCY) ( ) O1 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STKN. SER. STAT. EQ. CO. INC. STATE LIP <br /> CITY CA 95202 <br /> STPEET ADDRESS STOCKTON <br /> 808 N. UNION <br /> II FACILITY <br /> OEALEP./FO P.EMAN/SVPEPV250R <br /> FACILITY NAME <br /> STOCKTON SERVICE STATION EQ. C - - <br /> NEAREST CROSS STREET <br /> STREET ADDRESS 0 �_ <br /> 808 N. UNION <br /> ZIP <br /> C TY 95202 <br /> CITY SAN JOAQUIN <br /> STOCKTON <br /> STATE ZIP <br /> CITY 7S�aI <br /> MAILING ADDRESS �j STOCKTON CA y9S20'rV <br /> ,6,8-tt-tlNF9N �.�. {3 �-5p <br /> TYPE OF BUSINESS <br /> PHONE W/AREA CODE ( ) 01 GASOLINE STATION (XI 02 OTHER <br /> 209-464-8333 <br /> NUMBER OF CONTA: ERS RURAL AREAS ONLY TOWNSHIP <br /> RANGE SECTION <br /> X <br /> III 24 HOUR EMERG�ANO <br /> Y CONTACT PERSON <br /> DAYS: NA ME(LAST N ME FIRHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) ANDPHONE W/AREA CODED-8333 SAME '1( <br /> ) <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> CONTAINER NUMBER 1 <br /> A. (X) 01 TANK ( ) 04 OTHER: <br /> B. MANUFACTURER (IF APPROPRIATE): MODESTO WELDING YEAR MFG: 1970 C. YEAR INSTALLED 1970 ( 1 UNKNOWN <br /> 0. CONTAINER CAPACITY: 2000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( l 01 WASTE (X) 02 PRODUCT <br /> F. DOES OTHE <br /> CONTAINER STORE <br /> RMOTOR <br /> VEHICLE <br /> FUEL <br /> ORMWASTE OIL <br /> 04 0IESEL 0( )YES <br /> 05 WAST020IOO (I1 YES <br /> OCHECK APPROPRIATE BOX(ES): <br /> tX) <br /> LEkDED 02 <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS Of PRIMARY CONTAINMENT: 10 (X) GAUGE ( ) INCHES ( ) CM ( ) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) Ol DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> 0. (X)(0� CARBON STEEL 07STEELSTAINLESS S(EEL08(BRO03 NZEFIBERG09SCOMPOSITE POLYVINYL l0NONHMETALLICLORIDE ( ) 05 CONCRETE <br /> INUM <br /> f 1 12 UNKNOWN ( .) 13 OTHER: <br /> PAGE 1 <br /> HSC04-070185 (10/18/85) <br />