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STATE ID NUMBER 00000059367002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ��1 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED 99 QELETE FROM FILE_(NO FEE) <br /> 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGET <br /> I OWNER <br /> NAME(CORPORATION,I NO IV IDV OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> 1.R,-S*f1rtOT' `.,(' ( ) Ol FED f ) 02 STATE f 1 03 /LOCAL <br /> STREET ADDRESS CITY STAT[ ZZP�,j �/ <br /> I, /z �, u d �; P�GA��1�c�. cA_ <br /> II FACILITY <br /> FACILITY NAM[ // DEALER/FOREMAN/SUURV}SOR 1ke <br /> STREET AGGRESS NEAREST CROSS STREET <br /> 1904 W. CHARTER WAY I-5 <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN �L'S2Jl _ ZO G <br /> MAILING ADDRESS CITY STATE ZIP <br /> STOCKTON CA 9riBBY?5_266 <br /> PHONE W/AREA CODE TYPE OF DVSSNESS <br /> 209-464-8328 rjp -"7 y/ f 1 01 GASOLINE STATION (X) 02 OTHER AG CHEM DISTR. <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 4 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODENIGHTS: NAME(LAST NAME FIRST) AND PHONE W/A A CODE <br /> ^ATTiY( ROPPeT 0� r� 447 SAME �6 <br /> D J /*we er 19 - 0 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. ( ) 01 TANK (X) 04 OTHER: UMP rr�� '' CONTAINER NUMBER 30001 <br /> B. MANUFACTURER (IF APPROPRIATE): D�"'O&OL,15 YEAR MF G• C. YEAR IN 1981 f 1 UNKNOWN <br /> 1le-o `rtre R h <br /> 0. CONTAINER CAPACITY: -i00D-wGALLONS f ) UNKNOWN E. DOES THE CONTAINER STORE: O1 WASTE ( ) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? ( ) 01 YES (X) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> f ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( 1 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 10 ( ) GAUGE (X) INCHES ( ) CM ( 1 UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED f 1 03 UNKNOWN <br /> C. ( ) Ol DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> 0. ( ) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( l 04 POLYVINYL CHLORIDE (X) 05 CONCRETE <br /> ( ) 06 ALUMINUM f 1 07 STEEL CLAD ( ) 08 BRONZE ( l 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> KSC04-070185 (10/18/85) PAGE 1 <br />