Laserfiche WebLink
STATE ID NUMBER 00000007080002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROU D STORAGE TANK <br /> OCl 01 NEW PERMIT f ) 05 RENEWED PERMIT 0CLOSED 6 S ( ) 09 DELETE FROM FILE (NO FEE) <br /> � 8 MINOR S 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) CHANGE 0SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION. NDIVIDUAL OR P CLIC AGENCY) PUBLIC AGENCY ONLY <br /> f ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITU STAT! ZIP <br /> 20400 E. ACAMPO CLEMENTS CA 95227 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> CENTRAL DISTRIBUTING <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 1100 E CHARTER WAY UNION <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95206 <br /> MAILING ADDRESS CITY STATE ZIP <br /> P. 0. BOX 8217 STOCKTON CA 95208 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-464-6461 ( 1 01 GASOLINE STATION (X) 02 OTHER ROOFING COMPANY <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 2 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AP.EA CODE NIGHTS: NAM!(LAST NAME FIRST) AND PHONE W/ARCA CODE <br /> e W ° *E 209-JU-3665.. NEIL BAYSINGER 209-477-0240 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (XI 01 TANK ( ) 04 OTHER) CONTAINER NUMBER 2 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 500 GALLONS ( 1 UNKNOWN E. DOES THE CONTAINER STORE: f ) 01 WASTE (XI 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? ( ) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( I <br /> 01 UNLEADED (X) 02 REGULAR f ) 03 PREMIUM ( ) 04 DIESEL f ! 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( I INCHES ( ) CM LX) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) f ) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( l 02 SINGLE WALLED f ) 03 LINED <br /> 0. (*) 01 CARBON STEEL ( l 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD f l 08 BRONZE f 1 09 COMPOSITE ( ) 10 NON-METALLIC <br /> U 4 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> y"r' <br />