Laserfiche WebLink
STATE ID NUMBER 00000011249002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( 1 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> t 1 02 CONDITIONAL PERMIT i l 06 AMENDED PERMIT i 1 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPCPATION,INDIVIDUAL OR PUBLIC ASENCYt PUBLIC AGENCY ONLY <br /> 01 FED ( ) 02 STATE X 03 LOCAL <br /> STREET ADDRESS (ry ,+� .-, CITY p STATE <br /> 9.0 <br /> II FACILITY ` s�4eL <br /> FACILITY NAME DEALER/FOREM.AN/SUPERVISOR <br /> SPEEDY FOOD #2 <br /> STPE£T ADDRESS NEAREST CROSS STREET <br /> 8200 N. HWY. 99 AND FOPPIANO R <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 2 3-L-4■1 <br /> MAILING ADD?$ S ,_ C TY �/ STATE ZIP , <br /> /_ �i F• <br /> PHONE W/AREA COD TYPE OF BUSINESS <br /> 915-672-6481 (XD 01 GASOLINE STATION ( l C2 OTHER <br /> NUMBER OF CONTAINEPSRURAL AREAS ONLY ; TOWNSHIP RANGE SECTION <br /> 3 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS; NAME(LAST NAME FIRST) AND PHONE W/AP.EA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/.ARE.A CODE <br /> CO TE THE FO N A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> S <br /> A. (X) 01 TANK ( ) 04 OTHER.: CONTAINER NUMBER 100 <br /> B. MANUFACTURER (IF APPROPRIATE)' JOOR YEAR MFG: C. YEAR INSTALLED 78 ( ) UNKNOWN <br /> 0. CONTAINER CAPACITY: 8101 GALLONS ( ) UNKNOWN JE. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CCNTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 01 YES ( l 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> (X) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( l 04 DIESEL ( ) 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: [ D GAUGE 1 ) INCHES ( D CM (X) U14KNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( l 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> D. (X) 01 CARSON STEEL ( ) 02 STAINLESS STEEL i ) 03 FIBERGLASS 1 1 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> [ ) 06 ALUMINUM ( ) 07 STEEL CLAD ( l 08 BRONZE i ) 09 COMPOSITE [ ) 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/1$!851 PAGE 1 <br />