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n//__ _ ,_„� / /��(jp� STATE ID NUMBER 00000017798011 <br /> APPLICATION FOR PERMIT TO DPERATE U DER ROUND STORAGE TANK <br /> fX) <br /> 01 NEW PERMIT ( 1 05 RENEWED PERMIT LJq 07 TANK CLOSED f 1 09 DELETE FROM FILE (NO FEEL <br /> L 1) 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT 'T 08 M-}INOR CH.4AGE-(NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> HOLT BROS. ( ) Ol FED l ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITYSTATE ZIP <br /> 1521 NEST-GHESTER WAY STOCKTON CA 95206 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/S PERVISOR <br /> HOLT BROS. BAY2O"t-MOS-'FIlk-A <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 1521 WEST 6HE67fR WAY INTERSTATE HWY 5 <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAgUIN 95206 <br /> MAILING ADDRESSCITY STATE ZIP <br /> P.O. BOX 8130 STOCKTON CA 95208 <br /> PHONE W/AREA CODE TYPE OFBUSI Nl SS <br /> 209-466-6000 f ) Ol GASOLINE STATION (X) 02 OTHER FARM <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGC SECTION <br /> Y <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 /> B#;LA9_Tl918TT 209-466-6000 -1/ <br /> lqt wGSF2'JV <br /> TE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 11 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: "Q GALLONS HH UNKNOWN E. DOES THE CONTAINER STORE: (X) 01 WASTE ( ) 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 /> ( 1 <br /> 01 UNLEADED ( l 02 REGULAR ( l 03 PREMIUM ( ) 04 DIESEL 1X1 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> B. 1 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) f Z NON-VAULTED t*r 03 UNKNOWN <br /> C. [ ) 01 DOUBLE WALLED ( l 02 SINGLE WALLED [ ) 03 LINED <br /> D. 1 1 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> f ) 06 ALUMINUM f ) 07 STEEL CLAD f 1 08 BRONZE f 1 09 COMPOSITE ( l 10 NON-METALLIC <br /> 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> � "J <br />