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ee ,,./j STATE ID NUMBER 00000032561002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( 1 <br /> 01 NEW PERMIT ( 1 05 RENEWED PERMIT07 TAMC CLOSED .k:V� 09 DELETE FROM FILE (NO FEE) <br /> f 1 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( 1 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> JIM M. YAMAUCHI ( ) 01 FED f ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESSCITY STATE ZZP <br /> 5764 N. BEECHER RD. STOCKTON CA 95205 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> JIM M. YAMAUCHI SELF EMPLOYED <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 5764 N. BEECHER RD. BAKER RD. <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95205 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 5764 N. BEECHER RD. STOCKTON CA 95205 <br /> PHONE W:AREA CODE TYPEOF BUSINESS <br /> 209-931-1850 ( ) 01 GASOLINE STATION IX) 02 OTHER TRUCKING <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 2 <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 /> YAMAUCHI, JIM M. 209-931-1850 SAME - <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER R2 <br /> B. MANUFACTURER (IF APPROPRIATE): STOCKTON MFG. A SALES CO. YEAR MFG: 1979 C. YEAR INSTALLED 1979 ( l UNKNOWN <br /> D. CONTAINER CAPACITY: 500 GALLONS f 1 UNKNOWN E. DOES THE CONTAINER STORE: ( l 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 01 YES f ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> (X) 01 UNLEADED f 1 02 REGULAR ( l 03 PREMIUM l 1 04 DIESEL ( ) 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 12 (X) GAUGE ( 1 INCHES ( ) CM ( ] 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 ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( l 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE f 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( 1 07 STEEL CLAD f ) 08 BRONZE ( 1 09 COMPOSITE ( 1 10 NON-METALLIC <br /> ( 1 12 UNKNOWN ( ) 13 OTHER: <br /> MSC04-070185 (10/18/85) PAGE 1 <br /> `w <br />