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V0VI I Ah° <br /> ;4�t STATE IO NUMBER 00000021724002 <br /> 6-1p n <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) 01 NEW PERMIT f ) 05 RENEWED PERMIT ( ) 07 TANK CLOSEDf ] 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT f ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARG ) <br /> I OWNER <br /> NAME(CORPORATION.INDIVIOUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> CASTELANELLI BROS ( ) 01 FED ( 1 02 STATE ( 1 03 LOCAL <br /> STREET ADDRESSCITY STATE ZIP <br /> 401 W ARMSTRONG R0. LOOI CA 95240 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> CASTELANELLI BROS <br /> STREET ADDPESS NEAREST CROSS STREET <br /> 401 W ARMSTRONG RD DAVID RD <br /> CITY COUNTY IIP <br /> LODI SAN JOAQUIN 95240 <br /> MAILING ADDRESS CITYSTATE IIP <br /> 401 W ARMSTRONG RD LODI CA 95240 <br /> PHONE W/AREA CODE TYPEOF BUSINESS <br /> 209-369-9218 ( ) 01 GASOLINE STATION (X) 02 OTHER DAIRY <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 2 <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 /> CASTELANELLI, LARRY 209-369-9218 - - <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 1 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 3000---GALLONS f 7 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 /> ( ) <br /> 01 UNLEADED (X) 02 REGULAR ( ) 03 PREMIUM ( l 04 DIESEL ( ) 05 WASTE OIL f ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: (X) GAUGE f l INCHES f ) CM f ) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) f ) 02 NON-VAULTED IX) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED ( ) 03 LINED <br /> O. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL 1 103 FIBERGLASS f ) 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( ] 09 COMPOSITE ( ) 10 NON-METALLIC <br /> f ) 12 UNKNOWN ( ) 13 OTHER: <br /> NSC04-070185 (10/18/85) PAGE 1 <br /> AlloF �RR� <br />