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• • STATE ID NUMBER' <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK' <br /> ...01_NEN._PERMIZ_. <br /> 05.RENEWED-PERMIT S 5..071ANK_c DSED - --L-J-,09_DELEIE..FROMJlLE_LNO_JEEl_ .� <br /> ( 1 02 CONDITIONAL PERMIT f ) 06 AMENDED PERMIT ( 108 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> HAM2(CORPORATXON.INDIVIDUAL OR PVSLIC AGENCY) PUBLIC AGENCY ONLY <br /> San Joaquin Count ( ) 01 FEO ( 1 02 STATE (x) 03 LOCAL <br /> STREET ADDRESS - CITY STATE ZIP 95202 <br /> 222 E. Weber.: Street Stockton CA <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SVPERVISOR <br /> Lov(�,Jace Transfer Station Tom Horton <br /> YTREAT ADDRESS NEAREST CROSS STREET <br /> Ai ort Way <br /> CITY COUNTY ZIP <br /> Manteca -San Joaquin 953.36 <br /> MAILING ADDRESS CITY STATE ZIP' <br /> p-0, Rox 1810 Stockton CA -95201 <br /> 'PHONE W/AREA CODE TYPE OF SUSZNKSS <br /> - ( ) <br /> 01 GASOLINE STATION (x) 02 OTHER Transfer Station . <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY i TOWNSHIP RANGE SKCY,LON - <br /> 1 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> bAYii NAMK(LAST NAME FIRST) AND PHONE W/AREA COOK NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. 01 TANK ( ) 04 OTHERS CONTAINER NUMBER <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG C. YEAR INSTALLED ( 1 UNKNOWN <br /> 0. CONTAINER CAPACITY: ICP ? GALLONS ( 1 UNKNOWN E. DOES THE CONTAINER STORE: l ! 01 HASTE (j' 02 PRODUCT <br /> ,F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WAS OIL ? (<01 YES l 1 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> 1 ) 01 UNLEADED f ) 02 REGULAR ( 1 03 PREMIUM 1 04 DIESEL l 1 OS WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> { <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( 1 GAUGE C.) INCHES ( ) CM l ) UNKNOWN <br /> ,B. l 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (M 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. l l 01 DOUBLE WALLED (ZN4 02 SINGLE WALLED 1 1 03 LINED <br /> D. f 1 01 CARBON STEEL l ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS f 1 04 POLYVINYL CHLORIDE I ) 05 CONCRETE <br /> ( ) 06 ALUMINUM 1 1 07 STEEL CLAD ( 1 08 BRONZE ( ) 09 COMPOSITE 1 ) 10 NON-METALLIC <br /> l ) 12 UNKNOWN ( 1 13 OTHER: <br /> KSC04-070185 (10/18/85) PAGE 1 <br />