Laserfiche WebLink
STATE ID NUMBER 00000062561005 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> (xl" O1 NEW PERMIT [ ) 05 RENEWED PERMIT (pQ 07 TANK CLOSED 6�y ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT f 1 08-RINDR-CRAIM (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> CHEVRON U.S.A. INC. I( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STPEET ADDRESS CITY STATE ZIP <br /> 575 MARKET SAN FRANCISCO CA 94105 <br /> II FACILITY <br /> FACILITY NAM DEALER/FOREMAN/SUPERVISOR <br /> 94054 /5 Q✓ DEVONSHIRE,DONALD <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 2103 COUNTRY CLUB BLV FRANKLIN <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95204 <br /> MAILING ADDRESSCITY STATE ZIP <br /> 2103 COUNTRY CLUB BLV STOCKTON CA 95204 <br /> PHONE W/AP.EA CODE TYPEOF BUSINESS <br /> 209-462-2575 (X) 01 GASOLINE STATION f ) 02 OTHER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY : TOWNSHIP RANGE SECTION <br /> 6 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAMI(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> MAINTENANCE DISPATCH 415-877-0244 - <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: 1964 C. YEAR INSTALLED 1964 [ ) UNKNOWN <br /> 0. CONTAINER CAPACITY: 2000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? ki 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> Od 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL f ) 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> a <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 0000170 ( ) GAUGE ( 1 INCHES ( ) CM ( 1 UNKNOWN <br /> B. ( 7 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. f ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED I ) 03 LINED <br /> D. OU 01 CARBON STEEL f 1 02 STAINLESS STEEL ( 1 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( ] 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />