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STATE ID NUMBER 00000004169006 <br /> '�� APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ,4. 01 NEW PERMIT f ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED <br /> [�) 02 CONDITIONAL PERMIT f ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE)) 09 DELETE FROM FILE (NO FEE) <br /> I OWNER <br /> NAME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> DELTA TRUCK SALES, INC. <br /> ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS <br /> CA 95208 <br /> ON <br /> 3655 E. CHEROKEE ROAD, P.O.BOX CITY STATE iia <br /> STOCKT <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> DELTA FLEET SERVICE L&M PETROELURI DISTRIBUTORS INC <br /> STREET ADORES$ NEAREST CROSS STREET <br /> 3535 N. CHEROKEE ROAD NEWTON ROAD <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOARUIN 95205 <br /> MAILING ADDRESS CITYSTATE ZIP <br /> 3535 N. CHEROKEE ROAD STOCKTON CA 95205 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-463-1470 (X) 01 GASOLINE STATION ( 7 02 OTHER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 10 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONQ W/AREA CODE <br /> 9AVAGET-Dict 209-948-9412 209- <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER UNLEADED 1 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 2000 GALLONS f ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 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 /> (X) 01 UNLEADED t 102 REGULAR [ 1 03 PREMIUM ( ) 04 DIESEL [ 1 05 WASTE OIL f 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: f ) GAUGE ( l INCHES ( ) CM (X) UNKNOWN <br /> B. ( ) Ol VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( 7 03 LINED <br /> D. (X) 01 CARBON STEEL ( 102 STAINLESS STEEL ( 7 03 FIBERGLASS ( 7 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> ( 1 06 ALUMINUM f 1 07 STEEL CLAD f 7 08 BRONZE 1 1 09 COMPOSITE ( 1 10 NON-METALLIC <br /> f 1 12 UNKNOWN ( ) 13 OTHER: <br /> MSC04-070185 (10/18/85) PAGE 1 <br /> 1.. 1—d <br />