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r� �ncK rc�iYrovE+� <br /> STATE ID NUMBER 00000064538001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> f 1 <br /> 01 NEW PERMIT ( ) 05 RENEWED PERMIT .J ) <br /> 08 09 DELETE FROM FILE (NO FEE1 <br /> l ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT MINOR CHANGE (NO SURCHARG l <br /> I OWNER <br /> NAME(CCPPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> FIRESTONE TIRE & RUBBER CO. ( ) 01 FED ( 7 02 STATE l 7 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 1200 FIRESTONE PKWY. AKRON ON 44317 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> FIRESTONE TIRE & RUBBER CO. M.N. PORTER <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 4905 CLAIRMONT <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95207 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 4905 CLAIRMONT STOCKTON ON 95207 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-478-3367 (X) 01 GASOLINE STATION f 1 02 OTHER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANOC SECTION <br /> 4 <br /> 111 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AR{A CODE <br /> M.W. PORTER 209-474-0739 SAME - - <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK f ) 04 OTHER: CONTAINER NUMBER 1 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG 3.977 C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 10000 GALLONS ( 1 UNKNOWN E. DOES THE CONTAINER STORE: f ) 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 ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL f ) 05 WASTE OIL f ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: f ) GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> B. ( 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( 1 01 DOUBLE WALLED ( ) 02 SINGLE WALLED ( l 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ] 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE l ) OS CONCRETE <br /> ( 1 06 ALUMINUM ( ) 07 STEEL CLAD l 1 08 BRONZE ( ] 09 COMPOSITE ( ] 10 NON-METALLIC <br /> ( ) 12 UNKNOWN [ ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />