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• • STATE I0 NUMBER 00000024773003 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> 41 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( 107 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> f ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( 1 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPOPATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> PACIFIC GAS AND ELECTRIC Cmwr ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STPEET ADDRESS CITY STATE ZIP <br /> 77 REALE STREET SAN FRANCISCO CA 94106 <br /> II FACILITY <br /> FACILITY NAME '_5 / r �-)�lL C-f� DEALER/FOREMAN/SUPERVISOR <br /> Y&.C.1 LL ITG...'J V-GI rt WILLIAM J. FRAZIER <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 4040 WEST LANE ALPINE <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95204 <br /> MAILING ADDRESS CITYSTATE ZIP <br /> P.O. BOX 930 STOCKTON CA 95201 <br /> PHONE W/APEA CODE TYPE OF BUSINESS <br /> 209-465-3867 f ) O1 GASOLINE STATION (X) 02 OTHER PUBLIC UTILITY <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 7 <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 CCOE <br /> DIVISION OPERATOR 209-465-6947 DIVISION OPERATOR 209-465-3867 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 3 <br /> B. MANUFACTURER (IF APPROPRIATE): - YEAR MFG: 1975 C. YEAR INSTALLED 1975 ( 1 UNKNOWN <br /> 0. CONTAINER CAPACITY: 12000 GALLONS f ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE fX) 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 /> (X) 01 UNLEADED t ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL f ) 05 WASTE OIL ( l 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( I INCHES f ) CM (X) UNKNOWN <br /> B. t ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( ] 02 STAINLESS STEEL ( l 03 FIBERGLASS f ) 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> ( ) 06 ALUMINUM f ] 07 STEEL CLAD ( 108 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> is 40 <br />