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\� �1-01 STATE ID NUMBER 00000002323003 <br /> APPLICATIOfN FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> OCI <br /> 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( 1 09 DELETE FROM FILE (NO FEE) <br /> 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPOPATION.INCIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> A. TEICHERT AND SON, INC. ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITY STATC 2I0 <br /> 3500 AMERICAN RIVER DR. SACRAMENTO CA 95851 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> STOCKTON YARD VIRGIL WHITE <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 103 NORTH E ST. D ST. <br /> .CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95201 <br /> MAILIN3 ADDRESS CITYSTATE ZIP <br /> P.O. BOX 1118 STOCKTON CA 95201 <br /> PHC NE W/AREA CODE TYPE OF BUSINESS <br /> 209-9iB-EgR'(FQ roo 1 ( ) 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 /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> NIGHTS: NAM!(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> WMZTE, VIRGIL 209-9y82YTI' v WHITES VIRGIL 209-823-5693 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK f ) 04 OTHER: CONTAINER NUMBER-Ei4-• <br /> 0. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> 0. CONTAINER CAPACITY: 10000 GALLONS f I 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 /> ( 1 <br /> 01 UNLEADED (X) 02 REGULAR ( 1 03 PREMIUM ( ) 04 DIESEL ( ) 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( ) INCHES f ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( 7 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( 1 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM f ) 07 STEEL CLAD ( 1 08 BRONZE ( 1 09 COMPOSITE ( ] 10 NON-METALLIC <br /> f ) 12 UNKNOWN ( 1 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />