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1, XP04 <br /> STATE IO NUMBER 00000021985004 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> l ) 01 NEW PERMIT l 1 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( l 09 DELETE FROM FILE (NO FEE1 <br /> l ) 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARG ) <br /> I OWNER <br /> NAME(CORPORATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> UNION PACIFIC RAILROAD CO. ( ) 01 FED f 1 02 STATE f ) 03 LOCAL <br /> STREET ADDRESS CITYSTATE ZIP <br /> 833 E 8TH STREET STOCKTON CA 95201 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> DIESEL FUEL FACILITY D.C. GOODSELL <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 833 E STH STREET <br /> CITY COUNTY IIP <br /> STOCKTON SAN JOAQUIN 95201 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 833 E STH STREET STOCKTON CA 95201 <br /> PHONE W/AREA CODE TYPEOF BUSINESS <br /> 209-466-2107 ( ) 01 GASOLINE STATION fX) 02 OTHER TRANSPORTATION <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SCCTION <br /> 9 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/ARCA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> 209-466-6401 209-466-6401 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 3 <br /> B. MANUFACTURER (IF APPROPRIATE): 1 YEAR MFG: 1969 C. TEAR INSTALLED (X) UNKNOWN <br /> 0. CONTAINER CAPACITY: 20000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: l ) 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 /> ( l 01 UNLEADED ( ) 02 REGULAR l l 03 PREMIUM (X) 04 DIESEL ( ) 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE f ) INCHES ( ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 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 ( l 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( 1 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />