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STATE ID NUMBER 00000051451001 <br /> APPLICATION FOR PERMIT TO 0 ERATE UNDERGROUND STORAGE TANK <br /> l l <br /> 01 NEW PERMIT ( ) 05 RENEWED PERMIT lQ�.S�ICYL.G�$EL1. �09 DELETE FROM FILE (NO FEE) <br /> ( 102 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT 1 1 8 MIN00 R CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COPPOPATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> VANDEPOL ENTERPRISES INC. ( ) 01 FED 1 ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS .CITYSTATE ZIP <br /> 2700 WEST WASHINGTON STOCKTON CA 95203 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> TOYS SERVICE STATION STEVE TOY <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 402 E. CHARTER WAY <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95206 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 402 EAST CHARTER WAY STOCKTON CA 95206 <br /> PHONE W/ARCA CODE TYPE OF BUSINESS <br /> 209-465-7690 (X) 01 GASOLINE STATION ( ) 02 OTHER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 3 <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 /> VANDEPOL, RONALD 209-465-3421 VANDEPOL, RONALD 209-957-1570 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 01 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 2000 GALLONS f 1 UNKNOWN E. DOES THE CONTAINER STORE: 1 ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? fX) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE SOX(ES): <br /> ( ) <br /> 01 UNLEADED fX) 02 REGULAR f ) 03 PREMIUM ( ) 04 DIESEL f ) 05 WASTE OIL f ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( l INCHES ( ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> D. fX) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS f ) 04 POLYVINYL CHLORIDE ( ) 03 CONCRETE <br /> t ) 06 ALUMINUM l ) 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE ( l 10 NON-METALLIC <br /> f ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />