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Y � STATE IO NUMBER 00000038434003 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) 01 NEW PERMIT ( 7 05 RENEWED PERMIT ( 07 TANK CLOSE ( 7 09 DELETE FROM FILE (NO FEE) <br /> ( l 02 CONDITIONAL PERMIT ( 7 06 AMENDED PERMIT 1 ) 0 E (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION,IND-IVIOUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> MELTON TRUCKING [PUBLIC <br /> 01 FED ( ) 02 STATE f ) 03 LOCAL <br /> STREET ADDRESS CITYSTATE ZIP <br /> 24169 S. CHRISMAN TRACY CA 95376 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> MELTON TRUCKING <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 24169 S. CHRISMAN <br /> CITY COUNTY ZIP <br /> TRACY SAN JOAQUIN 95376 <br /> rAILING ADOPESS CITYSTATE ZIP <br /> 24169 S. CHRISMAN TRACY CA 95376 <br /> PHONE W/APIA COOK TYPE OF BUSINESS <br /> 209-835-1093 ( 1 01 GASOLINE STATION (X) 02 OTHER <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 CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> ROD MELTON 209-836-2791 SAME - - <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 3 <br /> S. MANUFACTURER (IF APPROPRIATE): PERKINS YEAR MFG: 1970 C. YEAR INSTALLED 1970 f 1 UNKNOWN <br /> D. CONTAINER CAPACITY: 1500 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: l ) 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 /> ( 1 <br /> 01 UNLEADED ( ) 02 REGULAR ( l 03 PREMIUM (X) 04 DIESEL ( ) 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( ) 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. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE f ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( l 08 BRONZE f ) 09 COMPOSITE f ) 10 NON-METALLIC <br /> f ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/851 PAGE 1 <br /> IQ jp- <br /> \./ \J <br />