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' % STATE ID NUMBER 00000066296001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> l <br /> 01 NEW PERMIT ( ) 05 RENEWED PERMIT 7 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE1 <br /> •� 02 �ONDITIONAL PERMIT I ) 06 AMENDED PERMIT ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> STOCKTON YACHT CLUB INC. ( ) 01 FED ( ) 02 STATE ( 7 03 LOCAL <br /> STREET ADDRESS CITY STATE iIP <br /> 3235 RIVER DRIVE STOCKTON CA 95240 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> STOCKTON YACHT CLUB INC. MEL 80KIDES PETROLEUM <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 3235 RIVER DRIVE TELEGRAPH <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95240 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 3235 RIVER DRIVE STOCKTON CA 95240 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-946 9Q69 01 GASOLINE STATION (X) 02 OTHER PRIVATE MARINA <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY : TOWNSHIP RANGE SECTION <br /> 2 <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 /> FAIRM"emoReb209-Ql� � 6'!r-Q �� TELLER, IVAN 209-946-5755 <br /> WCr rs ON <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION , <br /> A. (X) 01 TANK ( 1 04 OTHER: CONTAINER NUMBER ONE <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 1000 GALLONS f ) UNKNOWN I E. DOES THE CONTAINER STORE: (X) 01 WASTE ( ) 02 PRODUCT <br /> F. DOES THE CONTAINEUTORE MOTOR VEHICLE FUEL OR WASTE OIL ? ( 1 01 YES l ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( ) 01 UNLEADED 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL 1 ) 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: X ( ) GAUGE (X) INCHES ( ) CM ( ) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. I ) 01 DOUBLE WALLED (X 02 SINGLE WALLED ( ) 03 LINED <br /> D. ( ) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( 1 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( 7 05 CONCRETE <br /> ( ) 06 ALUMINUM ( 1 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE l ) 10 NON-METALLIC <br /> dY.).i&""4WN ( ) 13 OTHER: <br /> HSC04-070185 (08/29/86) PAGE 1 <br />