Laserfiche WebLink
• • • • STATE ID NUMBER 00000009692001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) O1 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED <br /> ( 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE)) 09 DELETE FROM. FILE (NO FEE) <br /> I OWNER <br /> NAME(CORPORATION—NDIVIDUAL OR PUBLIC AGENCY) <br /> PUBLIC AGENCY ONLY <br /> ( ) 01 FED ( ) 02 STATE LOCAL <br /> STREET ADDRESS \-), • �� `.1y �7q� �J <br /> 940PBRIF all D� 7 ✓� I S CITY m VSA <br /> LIP4b2'ly 5�S <br /> II FACILITY <br /> FACILITY NAME <br /> WSP-STOCKTON- PLANT DEALER/FOREM /SUPERVISOR 7, <br /> WILLI AMS —T6 Pj UC" <br /> STREET AGGRESS <br /> 711 S. MADISON NEAREST CROSS STREET <br /> SCOTT <br /> CITY <br /> STOCKTON COUNTY IIP <br /> SAN JOAQUIN 95201 <br /> MAILING ADDRESS <br /> P.O. BOX 387 CITY <br /> STOCKTON STATE IIP <br /> PHONE W/AREA C00-c <br /> CA 95201 <br /> 209-948-3311 TYPE OF BUSINESS <br /> 01 GASOLINE STATION (X) 02 OTHER CONCRETE <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP <br /> 3 RANGE SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS' Nq�ME(LAS NAME FIRST) AND PHONE W/AREA CODE <br /> 209-948-3311 NIGHTS: N ST NAME FIRST) AND PHONE W/AREA CODE <br /> - '249'a4g7 <br /> T�7_ S63vtc M <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( l 04 OTHER: <br /> CONTAINER NUMBER WS9 <br /> B. 'MANUFACTURER (IF APPROPRIATE): <br /> YEAR MFG: C. YEAR INSTALLED (X7 UNKNOWN <br /> D. CONTAINER CAPACITY: 10000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: f ) 01 WASTE (X) 02 PRODUCT <br /> F. ( ) 01DOES ( )E CONTAINER 002 EREGULARMOTOR VE(I)L03FUEL OR PREMIUMWASTE(X) 04 OIL <br /> DIESEL ( ) 05 WASTE OIL ( ) 06 OTHER <br /> (X) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( ) ,INCHES ( ) CM !X7 UNKNOWN - <br /> B• ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> ------------ <br /> C. ( 101 DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> 0. (X) O1 CARBON STEEL ( 7 02 STAINLESS STEEL ( 7 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE <br /> 12 UNKNOWN 13 OTHER: <br /> ( 1 10 NON-METALLIC <br /> ( 7 ( ) <br /> SC04-070185 (30/18/85) <br /> PAGE 1 <br />