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1./ STATE ID NUMBER 00000004169005 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> y,��.�02 NEW PERMIT ( ) 05 RENEWED PERMIT l ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> P 1 02 CO)JOITIONAL PERMIT f 1 06 AMENDED PERMIT [ 7 08 MZNOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COPPORATION,ZNDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> DELTA TRUCK SALES, INC. ( 7 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 3655 E. CHEROKEE ROAD, P.0.BOX STOCKTON CA 95208 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> DELTA FLEET SERVICE LtM PETROELUM DISTRIBUTORS INC <br /> STPEET ADDRESS NEAREST CROSS STREET <br /> 3535 N. CHEROKEE ROAD NEWTON ROAD <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95205 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 3535 N. CHEROKEE ROAD STOCKTON CA 95205 <br /> PHONE W/AREA COOK TYPEOF BUSINESS <br /> 209-463-1470 (X) O1 GASOLINE STATION f ) 02 OTHER <br /> NUMBER OF CONTAINERS PUPAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 10 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA COOS NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> e*v*9E7_4Zu_, 209-948-9412 5' 209-4s?' lb8 _ &,6 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER ULKL <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: 1983 C. YEAR INSTALLED 1983 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: GALLONS f 7 UNKNOWN E. DOES THE CONTAINER STORE= ( ) Ol WASTE (X7 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 01 YES f 7 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> (X) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL f 7 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 10 (X) GAUGE ( ) INCHES ( ) CM ( l UNKNOWN <br /> S. ( ) 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 /> 0. (X) 01 CARBON STEEL [ ) 02 STAINLESS STEEL ( 1 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE f ) 05 CONCRETE <br /> l ) 06 ALUMINUM t ) 07 STEEL CLAD ( 1 08 BRONZE f ) 09 COMPOSITE ( 7 10 NON-METALLIC <br /> l ) 12 UNKNOWN f 1 13 OTHER: <br /> HSC04-070165 (10/18/85) PAGE 1 <br />