Laserfiche WebLink
STATE ID NUMBER 00000012722001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( NEW PERMIT ( l 05 RENEWED PERMIT K CLOSED Ib ( ) 09 DELETE FROM FILE (NO FEE) 1 <br /> 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ) 08 M (NO SURCHARGE) <br /> I OWNER J <br /> N.AME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> MERTZ CONSTRUCITON ,INC. ( ) O1 FED t ) 02 STATE ( J 03 LOCAL <br /> STREET .ADDRESS CITY STATE ZIP <br /> 520 RAILROAD AVENUE LODI CA 95240 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREM.AN/SUPERVISOR <br /> MERTZ CONSTRUCTION INC. GARY L. MERTZ <br /> STREET .ADDRESS NEAREST CROSS STREET <br /> 520 RAILROAD AVENUE CHEROKEE LANE <br /> CITY COUNTY ZIP <br /> LODI SAN JOAQUIN 95240 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 520 RAILROAD AVENUELODZ CA 95240 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-334-2022 ( ) 01 GASOLINE STATION (X) 02 OTHER MASONRY CONTRATOR <br /> NUMBER. OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 1 <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 /> 209-334-2022 GARY L. MERTZ 209-951-5818 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( l 04 OTHER: CONTAINER NUMBER 1 <br /> B. MANUFACTURER (IF APPROPRIATE): PERKINS WELDING YEAR MFG: 1974 C. YEAR INSTALLED 1974 ( l UNKNOWN <br /> D. CONTAINER CAPACITY: 6000 GALLONS ( l UNKNOWN E. DOES THE CONTAINER STORE: ( l 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 /> ( ) <br /> 01 UNLEADED (X) 02 REGULAR ( l 03 PREMIUM ( ) 04 DIESEL ( l 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 10 (X) GAUGE ( l INCHES ( ) CM ( ) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( J 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( J 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( l 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( l 08 BRONZE ( l 09 COMPOSITE ( l 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> 0 <br />