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• • STATE I0 NUMBER 00000037266001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> 1 NEW PERMIT ( ) 05 RENEWED PERMIT ( 1 07 TANK CLOSED <br /> ( ) 09 DELETE FROM FILE (NO FEE) <br /> ] 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> PUBLIC AGENCY ONLY <br /> NAME(COPPORATION.SNDIVIDUAL OR PUBLIC AGENCY) ( ) Ol FED ( ) 02 STATE I 1 03 LOCAL <br /> WOODBRIDGE VINEYARD ASSOCIATIO <br /> CITY STATE IIP <br /> STREET ADDRESS LODI CA 95240 <br /> 4614 W. TURNER RD. <br /> II FACILITY <br /> 1 DEALER/FOREMAN/SUPERVISOR ,M 0.V'\ ( U', <br /> 1 <br /> FACILITY NAME 1 \ I \)� CIS �j��• D C 1 �.� 1' • L <br /> E IN ODa b( L v �7T <br /> NEAPEST CROSS STREET <br /> STPEET ADOPESS RAY RD. <br /> 4614 W. TURNER RD. ZIP <br /> COUNTY <br /> 95240 <br /> CITY SAN JOAQUIN <br /> LODI <br /> STATE ZIP <br /> CITY CA 95240 <br /> MAILING ACDFEss LODI <br /> 4614 W. TURNER. RD. <br /> PHONE W/APE.A CODE TYPE OF BUSINESS <br /> 209-369-2614 ( ) 01 GASOLINE STATION (X) 02 OTHER FARMERS' COOPERATIVE <br /> NUMBER OF CONT ASNERS RURAL AREAS ONLY TOWNSHIP <br /> 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/AP.EA CODE <br /> MANI LDI, STEPHEN 209-369-2614 <br /> MANIOLI, STEPHEN 209-368-7634 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> a <br /> CONTAINER NUMBER 1 <br /> A. (X) 01 TANK f ) 04 OTHER: <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X1 UNKNOWN <br /> D. CONTAINER CAPACITY: 500 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> F. DOESOTHE CONTAINERXSTORERMOTOR VEHICLE FUEL ORMWASTE OIL04 OIESEL O( )E05 WASTES 0 IOL f21 06F YE 50THERK APPROPRIATE BOXf E51: <br /> LEADED <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNE!4! <br /> RY CONTAINMENT: ( ) GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> B. f I O1 CATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED f ) 03 UNKNOWNC. I 1 O1 LED ( 2 SINGLE WALLED ( l 03 LINEDD. (X) 01 EL ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE( ) M ( ) 07 STEEL CLAD ( ) 08 BRONZE f ) 09 COMPOSITE t ) 10 NON-METALLIC <br /> f l 12 ) 13 OTHER: <br /> PAGE 1 <br /> HSC04-070185 (10/18/85) <br />