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i i <br /> STATE IO NUMBER 00000006826003 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> N W ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED (Y) 09 DELETE FROM FILE (NO FEE) <br /> ( }}P .L PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE <br /> I OWNER <br /> NAME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> BERNARD A. WEVER ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 777 S. LOCUST RIPON CA 95366 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> BERNARD A. WEVER BERNARD A. WEVER <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 777 S LOCUST 5TH <br /> CITY - COUNTY ZIP <br /> RIPON SAN JOAQUIN 95366 <br /> MAILING ADDRESS CITY STATE ZIP <br /> P.O. BOX 434 RIPON CA 95366 <br /> PHONE W/APEA CODE TYPE OF BUSINESS <br /> 209-599-6666 ( ) 01 GASOLINE STATION (X) 02 OTHER TRUCKING TERMINAL <br /> NUMBER OF CONTAIN''-RS PUPAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 3 <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 /> WEVER-BERNAR" 209-599-6661 "EVER BERHAR^B-A. 209-599-6661S, <br /> I✓�u�. Xdytt <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 3 <br /> B. MANUFACTURER (IF APPROPRIATE): MODESTO TANK YEAR MFG: C. YEAR INSTALLED 1981 f ) UNKNOWN <br /> 0. CONTAINER CAPACITY: 3000 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 /> ( ) 01 UNLEADED ( ) 02 REGULAR ( 1 03 PREMIUM (X) 04 DIESEL ( 1 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: f ) GAUGE ( 1 INCHES ( ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X1 02 NON-VAULTED ( ) 03 UNKNOWN ` <br /> C. ( ) 01 DOUBLE WALLED (x) 02 SINGLE WALLED ( 1 03 LINED <br /> D. (X) 01 CARBON STEEL ( 1 02 STAINLESS STEEL ( ) 03 FIBERGLASS f ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD f ) 08 BRONZE f ) 09 COMPOSITE ( 1 10 NON-METALLIC <br /> f 1 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> i • <br />