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,/c STATE ID NUMBER 00000038434004 <br /> APPLICATION FOR PERMIT TO OPERAT UNDERGROUND STORAGE TANK <br /> ( ) <br /> 01 NEW PERMIT f ) 05 RENEWED PERMIT f 11 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT ( ) (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION•INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> MELTON TRUCKING ( ) 01 FED ( ) 02 STATE f 7 03 LOCAL <br /> STREET A.DOPESS CITY STATE 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 /> MAILING ADDRESS CITYSTATE ZIP <br /> 24169 S. CHRISMAN TRACY CA 95376 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-835-1093 ( 1 01 GASOLINE STATION (X) 02 OTHER <br /> NUMBER. OF CONTAINERS RURAL AREAS ONLY TOWNSHIPRANGE 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 ( l 04 OTHER: CONTAINER NUMBER 4 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 250 GALLONS ( ) UNKNOWN I 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 B0X(E5): <br /> ( ) 01 UNLEADED (X) 02 REGULAR ( ) 03 PREMIUM f ) 04 DIESEL ( ) 05 WASTE OIL f ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( 1 GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( ) 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( ] 02 SINGLE WALLED ( ] 03 LINED <br /> D. ( ) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS f 1 04 POLYVINYL CHLORIDE ( 7 05 CONCRETE <br /> f 1 06 ALUMINUM ( 1 07 STEEL CLAD ( 1 08 BRONZE f ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> (X) 12 UNKNOWN f ) 13 OTHER: <br /> • HSC04-070185 (10/18/85) PAGE 1 <br />