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STATE ID NUMBER 00000064782004 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( <br /> 01 NEW PERMIT ( 1 05 RENEWED PERMIT ( J 07 TANK CLOSED ( 1 09 DELETE FROM FILE (NO FEE) <br /> l 02 CONDITIONAL PERMIT i ) 06 AMENDED PERMIT ( 1 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CCRPC=.LTION,INDIVIDUAL OR PUBLIC AGENCi ) PUBLIC AGENCY ONLY <br /> GENERAL MILLS INC. ( ) 01 FED l ) 02 STATE t ) 03 LOCAL <br /> STREET ACDPEGS CITY STATE ZIP' <br /> 9200 WAYZATA BLVD. MINNEAPOLIS MN 55246 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> GENERAL MILLS INC. LODI PLANT J. MARTIN MAINT. MGR. <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 2000 W. TURNER ROAD MILLS AVENUE <br /> CITY COUNTY ZIP <br /> LODI SAN JOAQUIN 9524116 <br /> MAILING ADDRESS CITY STATELZ95241IWft <br /> IP <br /> P.O. BOX 3002 LODI CA <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-369-3541 ( ) 01 GASOLINE STATION fXl 02 OTHER MANUFACTURING <br /> NUMBER OF CONTAINERS PUPAL APEAS ONLY TOWNSHIP RANGE SECT'a0N <br /> 6 <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 /> J. MARTIN 209-334-7025 SECURITY 209-334-7039 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK f ) 04 OTHER: CONTAINER NUMBER,(/I ; L <br /> B. MANUFACTUPER (IF APPROPRIATE): MODESTO WELDING YEAR MFG: 1967 C. YEAR INSTALLED 1467 ( 1 UNKNOWN <br /> 0. CONTAINER CAPACITY: 12000 GALLONS ( 1 UNKNOWN E. DOES THE CONTAINER STORE. t ) 01 WASTE (X) 02 PRODUCT <br /> F, DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? ( ) 01 YES (X) 02 NO IF YES CHECK APPROPRIATE SOXfES): <br /> ( ) 01 UNLEADED ( ) 02 REGULAR ( 1 03 PREMIUM ( ) 04 DIESEL I ) 05 WASTE OIL I ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> p <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 1/4 ( ) GAUGE (X) INCHES ( ) CM ( 1 UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( 1 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( 1 03 LINED <br /> 0. (X) 01 CARBON STEEL [ ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> f ) 06 ALUMINUM i ) 07 STEEL CLAD ( 1 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER. <br /> HSC04-070185 (10/18/85) PAGE 1 <br />