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�--�, <br /> STATE ID NUMBER 000001864001 / <br /> 'y APPLICATION FOR PERMIT TO `OlPERATE UNDERGROUND STORAGE TANK <br /> ( A) 01 NEW PERMIT ( ) 05 RENEWED PERMIT q0) 07 TANK CLOSED ,/►,1 09 DELETE FROM FILE (NO FEE) <br /> 2 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT T ) 08 MINOR CHANGE (NO SURCHARfsEI <br /> I OWNER <br /> NAME(CORPORATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> PAUL UMDENSTOCK ( ) 01 FED ( 1 02 STATE 03 LOCAL <br /> STREET ADDRESS CITYSTATE ZIP <br /> 711 E. MINER STOCKTON CA 95201 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> BIG VALLEY FORD PAUL UMDENSTOCK <br /> STREET ADDU o NEAREST CROSS ST EET <br /> 711 <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95201 <br /> MAILING ADDRESS CITY STATE ZIP <br /> P.O. BOX 1729 STOCKTON CA 95201 <br /> PHONE W/ARCA CODE TYPEOF BUSINESS <br /> 209-466-5211 ( ) 01 GASOLINE STATION (XI 02 OTHER NEW CAR DEALER I <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 4 <br /> III 24 HOUR EMERGENCY CONTACT PERSON j <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> UMDENSTOCK, PAUL 209-466-5211 - <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 1 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED 1965 ( 1 UNKNOWN <br /> D. CONTAINER CAPACITY: 2000 GALLONS f ) 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 /> (X) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( I OS 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) ( 1 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED I ) 02 SINGLE WALLED f ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL f 1 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE f 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD f ) 08 BRONZE ( l 09 COMPOSITE ( 1 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( 1 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> low <br />