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• • STATE ID NUMBER 00000051716001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) 01 NEW PERMIT ( 7 OS RENEWED PERMIT f 1 07 TANK CLOSED <br /> ( ) 09 DELETE FROM FILE (NO FEE) <br /> 1 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT O 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPOPATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> ( ) Ol FED ( ) 02 STATE ( ) 03 LOCAL <br /> REICHS GROCERY <br /> CITY STATE ZIP <br /> STREET ADDRESS J TRACY CA 95376 <br /> 7505 W. LINNE <br /> II FACILITY <br /> DEALER/FOREMAN/SUPERVISOR <br /> FACILITY NAME <br /> REICHS GROCERY DAVE REICH <br /> NEAREST CROSS STREET <br /> 75STREET ADDRESS CHRISMAN <br /> 05 W. LINNE <br /> COUNTY Z-P <br /> TRACY _CITY SAN JOAQUIN 95376 <br /> CITY STATE ZIP <br /> MAILING ADDRESS TRACY CA 95376 <br /> 7505 W. LINNE <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-835-3700 (X1 O1 GASOLINE STATION ( 1 02 OTHER <br /> RURAL AREAS ONLY <br /> To <br /> RANGE SECTION <br /> NUMBER OF CONTAINERS 5E 3 <br /> 2 3S <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 /> DAVID REICH 209-835-3700 DAVID REICH 209-836-4270 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. tX) O1 TANK ( ) 04 OTHER: CONTAINER NUMBER 1 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> 0. CONTAINER CAPACITY: 1500 GALLONS ( 1 UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> F Df X1SO1HUNLEADEDNER ST02EREGUMOTOR <br /> LARVE`IC L03F PREMIUMUEL OR WASTE 04LD IESEL 0( ]YES <br /> 05 WASTE 2OIIOL (Il 06YES <br /> OTHERCHECK <br /> APPROPRIATE BOXES): <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: f l GAUGE ( 1 INCHES ( 1 CM (X) UNKNOWN <br /> B. ( 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) [() 02 NON-VAULTED W-4- 03 UNKNOWN <br /> C. f ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED ( ) 03 LINED <br /> 0. ( 1 01 CARBON STEEL ( 1 02 STAINLESS STEEL ( 1 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> f ) 06 ALUMINUM ( ) 07 STEEL CLAD ( 1 08 BRONZE ( 1 09 COMPOSITE l 1 10 NON-METALLIC <br /> IX) 12 UNKNOWN ( ) 13 OTHER: <br /> PAGE 1 <br /> HSC04-070185 (10/18/85) <br /> 10 0 <br />