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Jl; <br /> STA ID NUMBER -880Q40 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND S RAGE TANK/ <br /> �.1 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED f ) 09 DELETE FROM FILE (NO FEE) <br /> f 1 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT ( 1 08 MINOR CHANGE (NO SU ARSE) <br /> I OWNER <br /> NAME(CORPORA7ION.IN0IVIDUAI OR FUELIC AGENCY) PUBLIC AGENCY ONLY <br /> RAYMOND INVESTMENT CORPORATION ( ) 01 FED l 1 02 STATE ( 1 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 817 S. CENTER ST. STOCKTON CA 95206 <br /> II FACILITY <br /> FACILITY NAME / DEAL FOREMA /SUPERVISOR <br /> z <br /> STREET ADvpes NEAREST CROSS STREET <br /> CITY COUNTY IIP <br /> STOCKTON SAN JOAQUIN 95208,` <br /> MAILING ADDRESS CITYSTATE ZIP <br /> P-e -BCX-stl 1780 STOCKTON CA 9520]= <br /> PHONE W/APEA CODE <br /> H9NECODETYPE1 OF BUSINESS Ol GASOLINE STATION (X) 02 OTHER�(((�(�� <br /> NUMBER OF CONTTTAZNERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AAPEA CODE NIGHTS: NAME(LAS�TNNAME FIRST) AND PHONE W/AREA CODE <br /> RA*Mglsg, lo.vr L074 '( 209 9L'- <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 65 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (A4 UNKNOWN <br /> D. CONTAINER CAPACITY: 10000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 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 /> (LU 01 UNLEADED HH 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( ) 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( ) INCHES ( 1 CM (X) UNKNOWN <br /> B. f 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) 4) 02 NON-VAULTED I-X+ 03 UNKNOWN <br /> C. ( l 01 DOUBLE WALLED ( ) 02 SINGLE WALLED f 1 03 LINED <br /> 0. lJQ 01 CARBON STEEL ( l 02 STAINLESS STEEL f 1 03 FIBERGLASS f ) 04 POLYVINYL CHLORIDE t ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD f ) 08 BRONZE [ 1 09 COMPOSITE f ) 10 NON-METALLIC <br /> WF) 12 UNKNOWN f 1 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> 1`r \1 <br />