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TE 10 NUMBER -0800004435EOT0 <br /> APPLICATION FOR PE MIT TO OPERATE UNDERGROU STORAGE TANK <br /> 41 01 NEW PERMIT ( ) OS RENEWED PERMIT f ) 07 TANK CLOS f 7 09 DELETE FROM FILE (NO FEE) <br /> l t 02 CONDITIONAL PERMIT [ 1 06 AMENDED PERMIT ( l 08 MIN ANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION,INDIVIDUAL OR P AGENCY) PUBLIC AGENCY ONLY <br /> RAYMOND INVESTMENT CORPORAT ( ) 01 FED ( ) 02 STATE f ) 03 LOCAL <br /> STREET ADDRESS CITY STATF ZIP <br /> 1817 S. CENTER ST. T STOCKTON CA 95206 <br /> II FACIL Y <br /> fPACIL ITY N4 ' Qr_ 7yu P ` , DEALER./fyR A9 <br /> PER1ISOR <br /> ck <br /> STPEET. AGES �/, �J NEAREST CROSS STREET <br /> OO <br /> CITY COUNTY ZIP <br /> 520'MSTOCKTON SAN JOAQUIN 9520%.1:- <br /> HAILING <br /> AILING ADDRESSCITY STATE ZIP <br /> � <br /> p..0--66Kibi DO STOCKTON CA 9520 ^ <br /> PHONE W/AP EA CODCTYPE Of BUSINESS <br /> 209-Obi-A6C4- i ( ) 01 GASOLINE STATION (X) 02 OTHER T C <br /> NUMBER Of CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> .33' <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAV S: NAME(LAST NAME fIRSTI AND PHONE W/AREA CODE NI GNTS: NAME(IAST NAME FIRST) AND PHONE W/AREA CODE <br /> . / 209-46PHONE W/ _ RAYMBNDi�tl- � 2T) AND HONE <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER O6 <br /> S. MANUFACTURER (IF APPROPRIATE�): , UNKNOWN YEAR MFG: C. YEAR INSTALLED W4 UNKNOWN <br /> f <br /> D. CONTAINER CAPACITY: 14"Ve GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: f 1 01 WASTE ( l 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTEOIL ? f 1 01 YES f ] 02 NO IF YES CHECK APPROPRIATE BOXfE31: <br /> ( ) 01 UNLEADED ( ) 02 REGULAR ( 1 03 PREMIUM 04 DIESEL ( ) 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( 1 INCHES f 1 CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) )_02 NON-VAULTED Wr O3 UNKNOWN <br /> C. ( 1 01 DOUBLE WALLED f 1 02 SINGLE WALLED l ) 03 LINED <br /> 0. f kS O1 CARBON STEEL ( ) 02 STAINLESS STEEL ( l 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> �( ) 06 ALUMINUM ( ) 07 STEEL CLAD [ ) 08 BRONZE f ) 09 COMPOSITE f ) 10 NON-METALLIC <br /> W) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/16/85) PAGE 1 <br /> %bw NVI <br />