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STATE ID NUMBER 00000049788001 <br /> APPLICATION FOR PERMIT TO OPE E UNDERGROUND STORAGE TANK <br /> ( <br /> 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( ANK CLOSED ( l 09 DELETE FROM FILE (NO FEE) <br /> ( 7 02 CONDITIONAL PERMIT l 1 06 AMENDED PERMIT 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION,IND VIOUAL OR PUBLIC AGE CY) PUBLIC AGENCY ONLY <br /> JOSEPH D. SHEFFIELD ( ) 01 FED ( 1 02 STATE 1 7 03 LOCAL <br /> STREET ADDRESS CITY STATE IIP <br /> 5724 CHEROKEE RD. STOCKTON CA 95205 <br /> II FACILITY <br /> FACILITY NAMEDE LER/FOREMAN/SUPERVISOR <br /> SHEFFIELD RESIDENCE <br /> STPEET ADDRESS NEAREST CROSS STREET <br /> 5724 CHEROKEE RD. WILMARTH <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95205 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 5700 CHEROKEE RD STOCKTON CA 95205 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-931-0684 ( l Ol GASOLINE STATION (X) 02 OTHER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY : TOWNSHIP RANGE SECTION <br /> I 62 <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 /> SHEFFIELD JOE 209-9&k-4&T'1 �3��$ SAME <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. IX) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 1 <br /> S. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: GALLONS IX) UNKNOWN E. DOES THE CONTAINER STORE: (X) 01 WASTE ( 1 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 /> ( l 01 UNLEADED ( 1 02 REGULAR l 1 03 PREMIUM ( 1 04 DIESEL (X) 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( 1 GAUGE ( l INCHES ( 7 CM (X) UNKNOWN <br /> B. l 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( 02 NON-VAULTED HH 03 UNKNOWN <br /> C. ( 1 01 DOUBLE WALLED ( 1 02 SINGLE WALLED ( l 03 LINED <br /> D. ( 1 01 CARBON STEEL [ 7 02 STAINLESS STEEL ( ) 03 FIBERGLASS [ 7 04 POLYVINYL CHLORIDE [ 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( 1 08 BRONZE ( 1 09 COMPOSITE f 1 10 NON-METALLIC <br /> (X) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> 4 <br />