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STATE ID NUMBER 00000004180001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> 101 NEW PERMIT ( 1 05 RENEWED PERMIT ( 1 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEEL <br /> 2 CONDITIONAL PERMIT ( l 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COPPOPATION.INDIVIDUAL OR PUBLIC AOE NCY PUBLIC AGENCY ONLY <br /> OWENS-ILLINOIS INC. a. ( � ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS C Y ra STATE ZIP <br /> ULA d � s3? <br /> II FACILITY <br /> FACILITY �n�G�� Cl r DEALER/FOREMAN/SUPERVISOR <br /> STREET ADDRESS NEAREST CPOSS STREET <br /> 400 W. VALPICO RD TRACY BLVD. <br /> CITY COUNTY ZIP <br /> TRACY SAN JOAQUIN 95376 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 400 W. VALPICO RD TRACY CA 95376 <br /> PHONE W/APEA CODE TYPE OF BUSINESS <br /> 209-836-1971 ( ) 01 GASOLINE STATION (X) 02 OTHER CORRUGATED BOX PLANT <br /> NUMBER. OF CONTAINERS RURAL AREAS ONLY : TOWNSHIP RANGE SECTION <br /> 3 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AP.EA CODE NIGHTS: NAME[LAST,NAME FIRST) AND PHONE W/AR A CODE /f2 R <br /> 9A•EHTF6HAR8 209-836-1971 <br /> COMP ETETH <br /> THE NG ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER FOT1 <br /> B. MANUFACTURER (IF APPROPRIATE): OWENS/CORNING YEAR MFG: C. YEAR INSTALLED 1979 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 20000 GALLONS ( 1 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 BOX(ES): <br /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM (X) 04 DIESEL ( 1 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: f ) GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> B. f 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( 1 03 UNKNOWN <br /> C. f ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( 1 03 LINED <br /> D. ( ) 01 CARBON STEEL ( 1 02 STAINLESS STEEL (X) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( l 07 STEEL CLAD ( 1 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( 1 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />