Laserfiche WebLink
f <br /> STATE ID NUMBER 00000065878001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> .L4UO1 NEW PERMIT f ) OS RENEWED PERMIT ( ) 07 TAMC CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION.INDIVIDVAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> SAN JOAQUIN COUNTY l 1 01 FED ( ) 02 STATE L-) 03 LOCAL <br /> STREET ADDRESS ,I CITY STATE 2IP <br /> PtiS�OFFi6E-8DX3814• x.21- E. Weber �'F. STOCKTON CA 9520x <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> OAK GROVE PARK j.ee J. EhriMH.Y'c(t Ma.YL. " <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 4520 W. EIGHT MILE ROAD I-S <br /> CITY COUNTY ZIP <br /> STOCKTON - SAN JOAQUIN 95209 <br /> MAILING ADDRESS , / EAA+ CITY STATE ZIP Gi <br /> ROST OP*tC BOY-1 t /)/SAO W. 1` k M-te STOCKTON CA 9saw <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-944-337- ( ) 01 GASOLINE STATION (X) 02 OTHER COUNTY PARK <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 /> 209- 37-- NIGHT WATCHMAN 209-944-2281 <br /> i <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK t l 04 OTHER: CONTAINER NUMBER j:t� / <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG= C. YEAR INSTALLED 19A w' UM(HOWN <br /> D. CONTAINER CAPACITY: a GALLONS ( 1 UNKNOWN E. DOES THE CONTAINER STORE: X 91 WASTE 04 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (Xf 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( ) 01 UNLEADED UKj 02 REGULAR 1 ) 03 PREMIUM ( ) 04 DIESEL ( ) OS WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: f ) GAUGE ( ) INCHES X/�l CM 00 UNKNOWN <br /> B. ( I 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) C, Qf NON-VAULTED '7 03 UNKNOWN <br /> C. ( I 01 DOUBLE WALLED (Xf 02 SINGLE WALLED ( ) 03 LINED <br /> CARBON STEEL ( ) 02 STAINLESS STEEL 1 ) 03 FIBERGLASS f ) 04 POLYVINYL CHLORIDE f ) 05 CONCRETE <br /> t 1 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE 1 ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (08/29/86) PAGE 1 <br />