Laserfiche WebLink
�., ✓ <br /> STATE IO NUMBER 00000058141003 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> (le 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( 1 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION,INOIVIDUAL OR PUBLIC AGENCY) PlR)LIC AGENCY ONLY <br /> LODI UNIFIED SCHOOL DISTRICT ( 1 01 FED ( ) 02 STATE CV-03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 815 WEST LOCKEFORD STREET LORI CA 95240 <br /> II FACILITY/�` � <br /> FACILITY NAME ��./ DEALER/FOREMAN/SUPERV SOR J I <br /> TRANSPORTATION DEPT. MERLE JEWETT, p� r Tin �4'49N <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 820 SO. CLUFF AVE. INDUSTRIAL WAY <br /> CITY COUNTY <br /> 2IP <br /> LODI SAN JOAQUIN 95240 <br /> MAILING ADDRESS CITYSTATE ZIP <br /> 815 WEST LOCKEFORD ST. LODI CA 95240 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-369-1146 ( ) 01 GASOLINE STATION (X) 02 OTHER SCHOOL <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 /> JEWETT, MERLE 209-369-1146 JEWETT, HER LE <br /> 209-578-3258 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 0-2 <br /> B. MANUFACTURER (IF APPROPRIATE): ARROW TANK YEAR MFG: 1984 C. YEAR INSTALLED 1984 ( I UNKNOWN <br /> D. CONTAINER CAPACITY: 10000 GALLONS ( l UNKNOWN E. DOES THE CONTAINER STORE: 1 ) 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 /> f 1 <br /> 01 UNLEADED ( ) 02 REGULAR [ ) 03 PREMIUM (X) 04 DIESEL ( 1 05 WASTE OIL f ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: .250 ( ) GAUGE (X) INCHES ( ) CM ( ) 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 ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( l 09 COMPOSITE ( 1 10 NON-METALLIC <br /> f ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070165 (10/18/85) PAGE 1 <br />