Laserfiche WebLink
STATE ID NUMBER 00000012406001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> AQ 01 NEW PERMIT ( 1 05 RENEWED PERMIT ( D7 TANK CLO EA -3 1S f ] 09 DELETE FROM FILE (NO FEE) <br /> ( 1 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (N SURCHARGE) <br /> I OWNER <br /> NAME(COPPOPATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> THE. SOUTHLAND CORPORATION - ( ) 01 FED ( ) 02 STATE ( 1 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 5820 STONERIDGE MALL ROAD, 031 PLEASANTON CA 94566 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> 7-ELEVEN FOOD STORE 2243-20304 .ALFRED A BETTY PENA <br /> STP ADDRESS NEAREST CROSS STREET <br /> 455 GRANTLINE BUTHrAN <br /> CITY COUNTY IF <br /> TRACY SAN JOAQUIN 95376 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 2937 VENEMANROAO MODESTO CA 95356 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-578-9716 (X) 01 GASOLINE STATION f 1 02 OTHER <br /> NUMBER 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 /> TOM EFAW 209-578-9716 TOM EFAW 209-527-0870 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 2$3041 <br /> B. MANUFACTURER (IF APPROPRIATE): UNKNOWN YEAR MFG: C. YEAR INSTALLED 1978 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 10000 GALLONS f ) UNKNOWN E. ODES THE CONTAINER STORE: f 1 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 /> ( ) 01 UNLEADED (X) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( ] 05 WASTE OIL f 7 06 OTHER <br /> V CONTAINER CONSTRUCTION. <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( 1 INCHES ( ) CM (X) UNKNOWN <br /> B. ( 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. l 1 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( 1 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS f ) 04 POLYVINYL CHLORIDE f ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( 1 07 STEEL CLAD ( 1 08 BRONZE ( l 09 COMPOSITE ( 1 10 NON-METALLIC <br /> l 1 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> ftw <br />