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• • STATE ID NUMBER 00000054350001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) <br /> 01 NEW PERMIT ( 1 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> f ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COPPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> PASHA BROS. ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STFEET ADDRESS CITY STATE ZIP <br /> 113 NORTH WALNUT RIPON CA 95366 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> PASHA BROS. INC. ARNOLD PASHA <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 113 NORTH WALNUT MAIN ST. <br /> CITY COUNTY IF <br /> RIPON SAN JOAQUIN 95366 <br /> CITY STATE ZIP <br /> MAILING ADDPESS CA 95366 <br /> 113 NORTH WALNUT RIPON <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-599-3716 ( ) 01 GASOLINE STATION (X) 02 OTHER BUSINESS <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: NAM (LAST NAME FIRST) AND PHONE W/AREA CODE <br /> PASNA, TOM 209-599-3716 PASHA, TOM 209-599-3450 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( 1 04 OTHER: CONTAINER NUMBER N1 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> 0, CONTAINER CAPACITY: 750 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( 1 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? ( 1 01 YES ( 1 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM f 1 04 DIESEL [ 1 05 WASTE OIL (X) 06 OTHER UNKNOWN <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( 1 GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> S. ( 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( l 01 DOUBLE WALLED ( 1 02 SINGLE WALLED ( ) 03 LINED <br /> D. ( ) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( 1 03 FIBERGLASS f ) 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD f 1 08 BRONZE ( 1 09 COMPOSITE ( 1 10 NON-METALLIC <br /> (X) 12 UNKNOWN ( ) 13 OTHER: <br /> PAGE 1 <br /> HSC04-070185 (10/18/85) <br />