Laserfiche WebLink
STATE IO NUMBER 00000008170002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> (Y 01 NEW PERMIT l ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> 02 CONDITIONAL PERMIT f ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> TIME OIL CO. ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 2737 W. COMMODORE WAY SEATTLE WA 98199 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> JACKPOT VINCENT F. BLANK <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 7200 S. EL DORADO HWY. 50 <br /> CITY COUNTY ZIP <br /> FRENCH CAMP SAN JOAQUIN 95231 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 7200 S. EL DORADO 4AME Fr95231 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-982-9813 (X) 01 GASOLINE STATION ( 1 02 OTHER <br /> NU;MSSR OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 3 <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 /> STINE, GEORGE E. 707-425-7195 SAME - <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. IX) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 683 <br /> B. MANUFACTURER (IF APPROPRIATE): MODESTO WELDING YEAR MFG: 1972 C. YEAR INSTALLED 1972 ( 1 UNKNOWN <br /> D. CONTAINER CAPACITY: 8000 GALLONS ( ) 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 /> Q 2a <br /> 01 UNLEADED ( ] 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( ) 05 HASTE OIL JLW06 OTHER BtEN8r0A3Dt2RC' <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 1/4 ( ) GAUGE (X) INCHES ( ) CM [ ) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( 1 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> D. (X) 01 CARBON STEEL f 1 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( ] 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( 1 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( 1 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />