Laserfiche WebLink
..i <br /> STATE IO NUMBER 00000035832001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> 1 ) <br /> 01 NEW PERMIT ( 7 05 RENEWED PERMIT X) 07 ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( ] 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( 1 08 MINOR CHAN E (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION,INOIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> EXXON CO. USA ( ) 01 FED ( ) 02 STATE ( ] 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 3410 E. SECOND ST. BENICIA CA 94510 <br /> II FACILITY <br /> FACILITY NAME (sr I CF DEALER/FOREMAN/SUPERVISOR <br /> RICK ZIMMERMAN <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 2941 NAVY DRIVE <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95206 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 2941 NAVY DRIVE STOCKTON CA 95206 <br /> PHONE W/AREA CODE TYPECF BUSINESS <br /> 209-943-5662 ( 1 O1 GASOLINE STATION (X) 02 OTHER PETROLEUM TERMINAL <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> I <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 /> MORTON, CHARLES E. 707-745-7648 MORTON, CHARLES E. 415-825-5256 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER EXN-1 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> 0. CONTAINER CAPACITY: 5000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? ( ) 01 YES (X) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL f 1 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( 1 INCHES ( ) CM (X) UNKNOWN <br /> B. I 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( 1 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( l 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD f 1 08 BRONZE [ 1 09 COMPOSITE ( 1 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />