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zinc �n moi` ow o-,-TL <br /> STATE IO NUMBER 00000035404001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND TORAGE TANK <br /> ( l 01 NEW PERMIT f ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED f 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( l 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARG <br /> I OWNER <br /> NAME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUB C AGENCY ONLY <br /> CALIFORNIA HIGHWAY PATROL ( O1 FED ( ) 02 STATE ( 1 03 LOCAL <br /> STREET ADDRESSCITY STATE ZIP <br /> P.O. BOX 898 SACRAMENTO CA 95804 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOR[ N/SUPERVISOR <br /> CALIFORNIA HIGHWAY PATROL <br /> STREET ADDRESS NEAREST ROSS STREET <br /> 385 W. GRANTLINE RD. <br /> CITY CO UN Y ZIP <br /> TRACY SA JOAQUIN 95376 <br /> MAILING ADDRESS CITY STATE ZIP <br /> P.O. BOX 1088 TRA CA 95376 <br /> PHONE W/ARIA CODE TYPE OF BUSINSS <br /> 916-322-5310 ( ) 01 GASOLINE TATION (X) 02 OTHER CHP <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY NSHIP RANGE SECTION <br /> 1 <br /> I1I 24 HOUR EMERGENCY CONTACT PERON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA COD NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> FACILITIES SECTION 916-322-5310 DISPATCHER 916-445-2211 <br /> COMPLETE THE FOLLOWIN ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. ( ) 01 TANK (X) 04 OTHER: SUMP CONTAINER NUMBER 266-2 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: G LONS (X) UNKNOWN E. DOES THE CONTAINER STORE: (X) 01 WASTE ( ) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOREHICLE FUEL OR WASTE OIL ? ( ) 01 YES (X) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( ) 01 UNLEADED ( ) 02 REGUL ( ) 03 PREMIUM ( ) 04 DIESEL f l 05 WASTE OIL [ ) 06 OTHER <br /> V CONTAINER CONSTR TION <br /> A. THICKNESS OF PRIMARY CONT NMENT: ( ) GAUGE f ) INCHES ( ) CM (X) UNKNOWN <br /> B. f 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED f l 03 LINED <br /> D. f ) 01 CARBON STEEL [ l 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE (X) 05 CONCRETE <br /> f ) 06 ALUMINUM ( ) 07 STEEL CLAD f ) 08 BRONZE ( l 09 COMPOSITE f ] 10 NON-METALLIC <br /> f ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> A� <br />