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�. STATE ID NUMBER 00000045931004 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( f 01 NEW PERMIT ( 1 05 RENEWED PERMIT ( 1 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> �) 02 CONDITICNAL PERMIT t ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAMEtCOP.POP.ATION,INDIVT—DUAL CR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> SAN JOAQUIN DELTA COMMUNITY CO ( ) 01 FED ( ) 02 STATE [ 1 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 5151 PACIFIC AVENUE STOCKTON CA 95207 <br /> II FACILITY <br /> FACILITY N.A,ME ,. ` OEALER/FOREM.AN.-'SUPEPVISOR <br /> SAN JOAQUIN DELTA COMMUNITY CO LfiJ �0� Ye,/6 <br /> STPEET ADD=ESS NEAREST CROSS STREET <br /> 5151 PACIFIC AVENUE YOKUT <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95207 <br /> r:AILI,NG ,ADOPESS CITY STATE ZIP <br /> 5151 PACIFIC AVENUE STOCKTON CA 95207 <br /> PHONE W/APE.A CODE TYPE OF BUSINESS <br /> 20q— r <br /> 7q r 5-D 2- Z— ( ) 01 GASOLINE STATION (XI 02 OTHER JR. COLLEGE <br /> NUMBER OF CONTAINERS PUPAL .AREAS ONLY TOWNSHIP RANGE SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAdME(LAST NAME FIPST) AND PHONE `WIAPEA $ <br /> CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> "� `1 <br /> -209-+ 7 Y- 'D2Z. EVERITT, DAN 209-369-5042 <br /> AJ b <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK i ) 04 OTHER: CONTAINER NUIEER SJDC - 4 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG= C. YEAR INSTALLED 1973 i ) UNKNOWN <br /> D. CONTAINER CAPACITY: 500 GALLONS ( 1 UNKNOWN €. DOES THE CONTAINER STORE: (X) 01 WASTE ( ) 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 /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM [ ) 04 DIESEL (X) 05 WASTE OIL [ ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 12 (X) GAUGE ( ) INCHES f ) CM f ) UNKNOWN <br /> B. f ) 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 /> 0. f ) 01 CARBON STEEL ( 1 02 STAINLESS STEEL f ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> i ) 06 ALUMINUM ( 1 07 STEEL CLAD ( ) 08 BRONZE ( 1 09 COMPOSITE f ) 10 NON-METALLIC <br /> ( 1 12 UNKNOWN (X) 13 OTHER: MILL STEEL PLATE <br /> HSC04-070185 (10/18/85) PAGE 1 <br />