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STATE ID NUMBER 00000008447002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) 01 NEW PERMIT f ) 05 RENEWED PERMIT (X) 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) PUBLIC AGENCY ONLY <br /> WESTERN FARM SERVICE ( ) 01 FED ( ) 02 STATE ( 7 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 1805 N. LAFAYETTE FRESNO CA 93705 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> VERNALIS BRANCH BUCHTER, D.F. <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 35100 HWY 33 WECTY <br /> CITY COUNTY ZIP <br /> VERNALIS SAN JOAQUIN 95385 <br /> MAILING ADDRESS CITY <br /> STATE ZIP <br /> 35100 HWY 33 VERNALIS CA 95385 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-835-7597 ( ) 01 GASOLINE STATION (X) 02 OTHER AG CHEM SALES 3 SERV <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 3 T3S R6E 27 <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 /> BUCHTER> D.F. 209-835-7597 BUCHTER, D.F. 209-527-7750 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( 1 04 OTHER: CONTAINER NUMBER 83073 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 10000 GALLONS f ) 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 ( ) 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( 7 GAUGE ( 7 INCHES [ l CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( 7 02 NON-VAULTED (X7 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED f ) 03 LINED <br /> 0. ( ) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> f ) 06 ALUMINUM ( ) 07 STEEL CLAD ( 7 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> (X) 12 UNKNOWN f ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />