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STATE ID NUMBER 00000066093002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> PERMIT ( 1 05 RENEWED PERMIT ( ) 07 TANK CLOSED f ) 09 DELETE FROM FILE (NO FEEL <br /> 1 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT ( 1 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION.INDIVIOUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> LODI LUMBER COMPANY. INC. ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESSCITY STATE IIP <br /> 1025 INDUSTRIAL WAY L00I CA 95240 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> LORI LUMBER COMPANY. INC. ffaucv cncrcp r a�QXsDY� <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 1025 INDUSTRIAL WAY HWY 99 <br /> CITY COUNTY ZIP <br /> LODI SAN JOAQUIN 95240 <br /> MAILING ADDRESS CITY STATE ZIP <br /> P.O. BOX 401 LODI CA 95240 <br /> PHONE W/AREA CODE TYPEOF BUSINESS <br /> 209-334-4633 ( ) 01 GASOLINE STATION (X) 02 OTHER LUMBER YARD <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 NIGXTS: NAM E(LAST NAME FIRST) AND PHONE W/AREA(p CODE <br /> ®fAlF'FOSTER 209-334-4633 209-3%-4&"_ - s 6 <br /> a P.Y bv� <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER EAST 1 <br /> B. MANUFACTURER (IF APPROPRIATE): PERKINS MFG. YEAR MFG: 1979 C. YEAR INSTALLED 1979 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 2000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER TORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> * O1 UNLEADED 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( 1 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( 7 INCHES ( ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> 0. (X) 01 CARBON STEEL ( l 02 STAINLESS STEEL f 1 03 FIBERGLASS ( l 04 POLYVINYL CHLORIDE f 1 05 CONCRETE <br /> f ) 06 ALUMINUM ( 1 07 STEEL CLAD I ) 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (08/29/86) PAGE 1 <br />