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STATE I0 NUMBER 00000044354001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( 1 <br /> 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED <br /> ( 1 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE)) 09 DELETE FROM FILE (NO FEE) <br /> I OWNER <br /> ENAME(CORPORATION,IN'DIVIDUAL OR PUBLIC AGENCY) <br /> IA WELDING SUPPLY CO. PUBLIC AGENCY ONLY <br /> ( ) Ol FED f ) 02 STATE ( ) 03 LOCAL <br /> DDRESSENTER ST. CITY STATE ZIP <br /> STOCKTON CA 95206 <br /> Ii FACILITY <br /> FACILITY NAME <br /> CALIFORNIA WELDING SUPPLY CO/T DEALER/FOREMAN/SUPERVISOR <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 1000 E. ELEVENTH ST. <br /> CITY <br /> COUNTY IIP <br /> TRACY SAN JOAQUIN 95376 <br /> MAILING ADDPESS CITY <br /> STATE IIP <br /> P.O. BOX 567 STOCKTON CA 95201 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-466-8604 ( ) 01 GASOLINE STATION (X) 02 OTHER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 1 <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 /> RAYMOND, W.V. 209-466-8604 RAYMOND, W.V. 209-517-792 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 02 <br /> S. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 1000 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 ? ( ) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL i 1 05 WASTE OIL ( 106 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: l ) GAUGE f ) INCHES f ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( ) 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( 1 02 SINGLE WALLED t ) 03 LINED <br /> D. ( ) 01 CARBON STEEL f ) 02 STAINLESS STEEL f ) 03 FIBERGLASS f ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> I ) 06 ALUMINUM f ) 07 STEEL CLAD ( ) 08 BRONZE f l 09 COMPOSITE t ) 10 NON-METALLIC <br /> (X) 12 UNKNOWN l ) 13 OTHER: <br /> HSC04-070185 (30/18/85) PAGE 1 <br /> 14 <br /> r� <br />