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STATE ID NUMBER 00000031539001 <br /> APPLICATION FOR PERMIT TO RA& UNDERGROUND STORAGE TANK <br /> ( 7 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(CCPPOPATICN.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> CITY OF STOCKTON MUNICIPAL UTI f 7 01 FED ( 1 02 STATE ) 03 LOCAL <br /> STREET AO?ESS CITY STATE <br /> .. 79S <br /> 2500 NAVY DRIVE STOCKTON CA <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> MAIN PLANT M*R5R*6L.GL.0W, SUPERVISOR mN( <br /> STP.EET ADDRESS NEAREST CROSS STREET <br /> 2500 NAVY DRIVE TILLIE LEWIS DRIVE <br /> CITY COUNTY IF <br /> STOCKTON SAN JOAQUIN 95206 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 2500 NAVY DRIVE STOCKTON CA 95206 <br /> PHONE W/.AREA CODE TYPE OF BUSINESS <br /> 209-� 11%5- ( ) 01 GASOLINE STATION (X) 02 OTHER WASTEWATER TREATMENT <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY : TOWNSHIP RANGE SECTION <br /> �l <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> 2tr1 <br /> OPERATOR IN CHARGE 209-4663yy smig OPERATOR IN CHARGE 209-466-M6,1 p\4 MU. <br /> l0 PI*k% LlyawA <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER T293 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED 1976 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 5000 GALLONS f ] UNKNOWN E. DOES THE CONTAINER STORE: ( ) 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 /> f ] <br /> 01 UNLEADED ( ) 02 REGULAR ( 1 03 PREMIUM (X) 04 DIESEL ( 1 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: .25 f ] GAUGE (X) INCHES ( ) CM f ] UNKNOWN <br /> B. t ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED f 1 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ] 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE ( ] 10 NON-METALLIC <br /> f ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />