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• <br />r1 <br />STATE ID NUMBER 00000024754001 <br />APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br />f�.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(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) <br />PACIFIC GAS AND ELECTRIC COMPA <br />STREET ADDRESS <br />77 BEALE STREET <br />II FACILITY <br />PUBLIC AGENCY ONLY <br />( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br />CITY STATE <br />ZIP <br />SAN FRANCISCO CA 94106 <br />FACILITY NAME CCGI�G <br />S ��BC(� <br />( ) GAUGE ( ) INCHES <br />( ) CM (X) UNKNOWN <br />B. <br />MANTECA SERVICE Cci iic! <br />VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON -VAULTED <br />( ) 03 UNKNOWN <br />DEALER/FOREMAN/SUPERVISOR <br />f ) 01 <br />DOUBLE WALLED ( ) 02 SINGLE WALLED ( <br />) 03 LINED <br />C. C. SPEARS <br />( 1 01 <br />( ) <br />STREET ADDRESS <br />) 03 FIBERGLASS f 1 04 <br />POLYVINYL CHLORIDE ( ) 05 CONCRETE <br />(XI 12 <br />10901 E. HWY 120 <br />BRONZE ( ) 09 COMPOSITE <br />( 1 10 NON-METALLIC <br />NEAREST CROSS STREET <br />AUSTIN <br />CITY <br />MANTECA <br />COUNTY <br />ZIP <br />SAN JOAQUIN <br />95336 <br />MAILING ADDRESS <br />P.O. BOX 930 <br />exrr <br />STATE <br />ZIP <br />STOCKTON <br />CA <br />95201 <br />PHONE W/AP.EA CODE <br />TYPE <br />OF BUSINESS <br />209-823-0494 <br />( ) <br />01 <br />GASOLINE STATION (X) 02 OTHER PUBLIC UTILITY <br />NUMBER OF CONTAINERS <br />RURAL AREAS <br />ONLY <br />TOWNSHIP <br />RANGE <br />1 <br />SECTION <br />IIII 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 />DIVISION OPERATOR 209-465-6947 DIVISION OPERATOR 209-465-3867 <br />COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br />IV DESCRIPTION <br />EA. (X) 01 TANK ( ) 04 OTHER: <br />CONTAINER NUMBER 9 <br />B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br />D. CONTAINER CAPACITY: 1000 GALLONS [ ) 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 SOX(ES): <br />(X) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( ) 05 WASTE OIL ( ) 06 OTHER <br />V CONTAINER CONSTRUCTION <br />A. <br />THICKNESS OF PRIMARY CONTAINMENT: <br />( ) GAUGE ( ) INCHES <br />( ) CM (X) UNKNOWN <br />B. <br />( 101 <br />VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON -VAULTED <br />( ) 03 UNKNOWN <br />C. <br />f ) 01 <br />DOUBLE WALLED ( ) 02 SINGLE WALLED ( <br />) 03 LINED <br />0. <br />( 1 01 <br />( ) <br />CARBON STEEL ( ) 02 STAINLESS STEEL ( <br />06 ALUMINUM <br />) 03 FIBERGLASS f 1 04 <br />POLYVINYL CHLORIDE ( ) 05 CONCRETE <br />(XI 12 <br />f ) 07 STEEL CLAD ( ) 08 <br />UNKNOWN ( ) 13 OTHER: <br />BRONZE ( ) 09 COMPOSITE <br />( 1 10 NON-METALLIC <br />aerne_nTm ne ..�.,e,e., <br />PAGE 1 <br />