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STATE ID <br /> UMBER <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGENTANK 00000013279001 <br /> _L441 NEW PERMIT ( ) 05 RENEWED PERMIT [ ) 07 TANK CLOSED <br /> ( ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( 7 08 MINOR CHANGE (NO SURCHARGED 09 DELETE FROM FILE (NO FEE) <br /> I OWNER <br /> NAME(CORPORATION.INDI VIDUAL OR PUBLIC AGENCY) <br /> CAL-SIERRA PIPE, INC. <br /> PUBLIC AGENCY ONLY <br /> STREET ADDRESS ( 7 01 FED ( ) 02 STATE 00 03 LOCAL <br /> 3033 S. HIGHWAY 99 carr <br /> STOCKTON STATE ZIP <br /> II FACILITY CA 95205 <br /> FACILITY NAME <br /> CAL-SIERRA PIPE, INC. DEALER/FOREMAN/SUPERVISOR <br /> STREET ADDRESS LARRY F. GORHAM <br /> X033 S. HIGHWAY 99 NEAREST CROSS STREET <br /> CITY <br /> MARIPOSA RD. <br /> STOCKTON COUNTY <br /> MAILING ADDRESS SAN JOAQUIN ZIP <br /> 95205 <br /> 3033 S. HIGHWAY 99 CITY <br /> STOCKTON STATE IIP <br /> PHONE W/AREA CODE CA95205 <br /> 209-466-0988 TYPE OF BUSINESS <br /> ( ) <br /> NUMBER OF CONTAINERS O1 GASOLINE STATION (X) 02 OTHER PIPE DEALER <br /> 1 RURAL AREAS ONLY TOWNSHIP <br /> RANGE SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br />. DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> NIGHTS: LARRY <br /> AT NAME FIRST) AND PHONE W/AREA CODE <br /> GORHAM, LARRY F. 209-466-0988 <br /> GORHAM, LARRYRRY F F. 415-284-9659 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: - <br /> CONTAINER NUMBER 1 <br /> 8. MANUFACTURER (IF APPROPRIATE): STOCKTON MFG. <br /> YEAR MFG 1967 C. YEAR INSTALLED 1968 ( 1 UNKNOWN <br /> 0. CONTAINER CAPACITY: 550 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? <br /> (X) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( 7 04 DIESEL 0( )E05 WASTE20IOL (I) Ob SO CHECK APPROPRIATE BOX(ES): <br /> V CONTAINER CONSTRUCTION <br /> L. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( 1 INCHES ( ) CM (X) UNKNOWN <br />�• ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br />• (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( 1 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( 1 <br /> Ob ALUMINUM ( ) STEEL CLAD ( 1 08 BRONZE <br /> 12 UNKNOWNOTHER: ( 1 09 COMPOSITE ( 1 10 NON-METALLIC 05 CONCRETE <br /> ( ) ( ) <br />:04-070185 (10/18/85) <br /> PAGE 1 <br />