Laserfiche WebLink
STATE ID NUMBER 00000042256003 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( 1 01 NEW PERMIT ( 1 05 RENEWED PERMIT ( 7TANK CLO ` f ] 09 DELETE FROM FILE (NO FEE) <br /> E 1 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT ( ) 008 <br /> _MINOR CCHANGE (M SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> JAMES R MILLER f ) 01 FED f ) 02 STATE f ) 03 LOCAL <br /> STREET ADDRESS CITU STATE ZIP <br /> 2687 N. BEECHER RD STOCKTON CA 95205 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> JAMES R MILLER CONCRETE <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 2687 N BEECHER RD HWY 26 <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95205 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 2667 N BEECHER RD STOCKTON CA 95205 <br /> PHONE W/AREA CODE TYPEOF BUSINESS <br /> 209-931-0728 ( ) 01 GASOLINE STATION (X) 02 OTHER CEMENT CONTRACTOR <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/ARG CODE <br /> JAMES MILLER 2D9-931-0728 SAME - <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 3 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED 1977 f 1 UNKNOWN <br /> 0. CONTAINER CAPACITY: 3SO 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 /> (X) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( 1 04 DIESEL ( ) 05 WASTE OIL f ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( 1 INCHES ( ) CM (X) UNKNOWN <br /> B. l 101 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 MON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( 1 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( 1 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( 107 STEEL CLAD ( ) 08 BRONZE ( 1 09 COMPOSITE f 1 10 NON-METALLIC <br /> f 112 UNKNOWN ( ) 13 OTHER: <br /> • HSC04-070185 (10/18/85) PAGE 1 <br />