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0 STATE ID NUMBER 00090021915004 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) O1 NEW PERMIT ( ) O5 RENEWED PERMIT (Xi 09 DELETE FROM FILE (NO FEE] <br /> i ) 02 CONDITIONAL PERMIT { ) 06 AMENDED PERMIT { ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION.INDIVIDUAL OR PUBLIC AGENCY) FICBLAGENCY ONLY <br /> ] 01 FED ( l 02 STATE ( 1 03 LOCAL <br /> ENDICH BROTHERS <br /> STCEET ADDPESS ECSITTOYC�TON <br /> STATE ZIP <br /> 101 S. WILSON WAY CA 95205 <br /> II FACILITY <br /> DEALER/FOREM.ANfSUPERVISOR <br /> FACILITY NAM= <br /> ENRICH BROS. TEXACO <br /> STPEET ADDPESS NEAREST CROSS STREET <br /> 101 S. WILSON WAY <br /> COUNTY ZIP <br /> CITY <br /> CITYON SAN JOAQUIN 95205 <br /> 4ILINu ADDRESS CITY STATE ZISTOCKTP <br /> 101 S. WILSON WAY STOCKTDN CA 95205 <br /> PHONE JfARE4 CCOE TYPE OF BUSINESS <br /> 000-000-0000 (X1 01 GASOLINE STATION ( ] 02 OTHER <br /> NUMBEP OF CONTAINERS PUPAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 4 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAM (LAST NAME FIRST) AND PHONE W/ARE.A CODE NIGHTS: NAME(LAST NAME FIRST)-AND-RHONE WlAREA CODE <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( l 04 OTHER: CONTAINER NUMBER 4 <br /> B. MANUFACTURER (IF APPROPRIATE)= YEAR MFG: C. YEAR INSTALLED ( ] UNKNOWN <br /> 0. CONTAINER CAPACITY ONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( 1 01 WASTE ( 1 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? C 1 01 YES ( 1 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> i 1 01 UNLEADED ( ) 02 REGULAR (X) 03 PREMIUM [ ) 04 DIESEL ( 1 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( I GAUGE ( 1 INCHES f ) CM ( ) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( ) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( 1 01 DOUBLE WALLED 4 ) 02 SINGLE WALLED ( ) 03 LINED <br /> D. 4 ) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( l 03 FIBERGLASS C l 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> { ) 06 ALUMINUM { ) 07 STEEL CLAD f ] 08 BRONZE [ ) 09 COMPOSITE ( 1 10 NON-METALLIC <br /> { ) 12 UNKNOWN ( ) 13 OTHER= <br /> PAGE I <br /> NSC04-070185 (10/18/85) <br />