Laserfiche WebLink
. STATE ID NUMBER 00000044628002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) <br /> 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COPPORATION,INDIVIDUAL OR PUBLIC AGENCY) lR(U <br /> BLIC AGENCY ONLY <br /> DAVID ROSE ) 01 FED ( ) 02 STATE i ) 03 LOCAL <br /> STREET ADDRESS <br /> [MANTECA <br /> Y STATE ZiP <br /> 1922 REDWOOD CA 195336 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> ROSE RANCH DAVID ROSE <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 13406 SOUTH HWY 99 LATHROP & FRENCH CAMP <br /> CITY COUNTY ZIP <br /> MANTECA SAN JOAQUIN 95336 <br /> MAILING ADDRESS FMANTECA <br /> Y STATE ZIP <br /> 1922 REDWOOD AVE. CA 95336 <br /> PHONE W/APE.A CODE TYPE OF BUSINESS <br /> 269-823-5343 ( ) 01 GASOLINE STATION (X) 02 OTHER RANCH <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 3 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAM (LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(L.AST NAME FIRST) AND PHONE W/ARE.A CODE <br /> ROSE, DAVID 209-823-5343 ROSE, DAVID 209-823-5343 <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 /> B. MANUFACTURER (IF APPROPRIATE)*. YEAR MFG FCYEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: GALLONS (X) UNKNOWN JE. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? ( ) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES)= <br /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( ) 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( ) 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED ( ) 03 LINED <br /> D. ( ) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( l 09 COMPOSITE ( l 10 NON-METALLIC <br /> (X) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />