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�'- ✓ STATE IO NUMBER 00000002323001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> Q _D1 NEW PERMIT ( 1 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( 1 02 CONDITIONAL PERMIT f 1 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CCFPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> A. TEICHERT AND SON, INC. ( ) 01 FED ( ) 02 STATE t ) 03 LOCAL <br /> CITY STATE ZIP <br /> STREET ADDRESS <br /> 3500 AMERICAN RIVER DR. SACRAMENTO CA 95851 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> STOCKTON YARD VIRGIL WHITE <br /> kTP!ET ADDRESS NEAREST CROSS STREET <br /> 103 NORTH E ST. D ST. <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95201 <br /> MAILING ADDRESS STATE ZIP <br /> P.O. BOX 1118 STOCKTON CA 95201 CITY <br /> PHONE W/APER CODE TYPE OF BUSINESS <br /> 209-44 -i42a 01 GASOLINE STATION (X) 02 OTHER MOTOR VEHICLE MAINTE <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 6 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DA)S: NAME(LAST NAME FIRST) AND PHONE W/AREA COD! NIOHTS: NAME)LAST NAME FIRST) AND PHONE W/AREA CODE <br /> WHITE, VIRGIL 209-948-[3'Pi I? -gam/ WHITE, VIRGIL 209-823-5693 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER ell- <br /> B. MANUFACTURER (IF APPROPRIATE): PERKINS WELDING CO. YEAR MFG: 1979 C. YEAR INSTALLED 1979 ( l UNKNOWN <br /> D. CONTAINER CAPACITY: 20000 GALLONS ( 1 UNKNOWN E. DOES THE CONTAINER STORE: f 1 01 WASTE (XI 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 /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM (X) 04 DIESEL ( 1 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: .250 ( 1 GAUGE (X) INCHES ( ) CM ( 1 UNKNOWN <br /> B. l 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( 1 03 UNKNOWN <br /> C. f ) 01 DOUBLE WALLED lXl 02 SINGLE WALLED ( 1 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( 1 03 FIBERGLASS f ! 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( 1 08 BRONZE f 1 09 COMPOSITE f ) 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />