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BILLING_PRE 2019
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0502551
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BILLING_PRE 2019
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Entry Properties
Last modified
4/19/2022 3:22:23 PM
Creation date
11/5/2018 6:13:12 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0502551
PE
2381
FACILITY_ID
FA0005487
FACILITY_NAME
MARCIS DIESEL SERVICE
STREET_NUMBER
2969
STREET_NAME
LOOMIS
STREET_TYPE
RD
City
STOCKTON
Zip
95205
CURRENT_STATUS
02
SITE_LOCATION
2969 LOOMIS RD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\L\LOOMIS\2969\PR0502551\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
1/14/2016 5:57:45 PM
QuestysRecordID
2977760
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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QVr'Ao -c�' 3I ► yl � 1 <br /> STATE ID NUMBER 00000009125DOZ <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) 01 NEW PERMIT ( 1 05 RENEWED PERMIT f6) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( 1 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT f ) 08 MINOR CHANGE lN0 SURCHARGE) <br /> I OWNER <br /> NAME(CCRPOPATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> J. A. STAFFORD AND JOHN ROAN ( ) 01 FED ( ) 02 STATE f 1 03 LOCAL <br /> $ <br /> TPEET ADDRESS CITY STATE ZIP <br /> 3811 NORTH ARDEN DRIVE EL MONTE CA 91731 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> STOCKTON TRANSPORTATION. INC. PRESIDENT: KEN CAPLES <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 2969 LOOMIS ROAD MARIPOSA <br /> CITY COUNTY IIF <br /> STOCKTON SAN JOAQUIN 95205 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 2969 LOOMIS ROAD STOCKTON CA 95205 <br /> PHONE W/AREA CODE TYPEOF BUSINESS <br /> 209-948-1494 ( 1 01 GASOLINE STATION (X) 02 OTHER TRUCKING FIRM <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIPRANGE SECTION <br /> 2 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAM14LAST NAME FIRST) AND PHONE W/ARCA CODE <br /> KENNETH CARL ES 209-948-1494 KENNETH CAPLES 916-685-4045 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 2 <br /> S. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED ( ] UNKNOWN <br /> D. CONTAINER CAPACITY: 5000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( 1 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 /> ( 1 01 UNLEADED ( 1 02 REGULAR ( 1 03 PREMIUM (X) 04 DIESEL ( ) 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( l INCHES ( ) CM (X) UNKNOWN <br /> B. ( 101 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( ) 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. ( 1 01 DOUBLE WALLED ( ) 02 SINGLE WALLED f 1 03 LINED <br /> D. ( ) 01 CARBON STEEL ( l 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( 1 08 BRONZE f ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> (X) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> �Nlw low <br />
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