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I K STATE ID NUMBER 00000012858001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> f ) O1 NEW PERMIT ( ) 05 RENEWED PERMIT f ) 09 DELETE FROM FILE 110 FEE) <br /> f ) 02 CONDITIONAL PERMIT l ) 06 AMENDED PERMIT OR CHANGE fNO SURCHARGE) <br /> I OWNER <br /> NAME(CORPOPATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> RIPON CANNING CO. 1 ) 01 FED ( ) 02 STATE ( 1 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 422 E. FAIRMONT MOD£STO CA 95351 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> DELTA FARM SERVICE DICK NORRIS <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 1164 BESSEMER INDUSTRIAL PARK DRIVE <br /> CITY COUNTY ZIP <br /> MANTECA SAN JOAQUIN 95336 <br /> MAILING ACDPESS CITYSTATE ZIP <br /> 1164 BESSEMER MANTECA CA 95336 <br /> PHONE I,'/AREA CODE TYPE OFDUSINESS <br /> 209-239-4158 ( 1 O1 GASOLINE STATION (X) 02 OTHER AG-CHEM <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 1 <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 /> NORRIS, RICHARD 209-239-4158 SMITH, JOHN 209-477-2629 <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 1978 t ) UNKNOWN <br /> D. CONTAINER CAPACITY: 1000 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 /> ( 1 01 UNLEADED ( ) 02 REGULAR f ! 03 PREMIUM (X) 04 DIESEL l 1 05 WASTE OIL t ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE l ) INCHES f ) CM (X) UNKNOWN <br /> B. ( 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( ) 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( l 02 SINGLE WALLED ( ) 03 LINED <br /> 0. ( 1 01 CARBON STEEL ( l 02 STAINLESS STEEL ( ) 03 FIBERGLASS f ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( 1 06 ALUMINUM f ) 07 STEEL CLAD ( l 08 BRONZE ( ) 09 COMPOSITE t ) 10 NON-METALLIC <br /> (X) 12 UNKNOWN ( 1 13 OTHER: <br /> HSC04-070185 (10/18/BS) PAGE 1 <br />