Laserfiche WebLink
APPLICATION FOR PERMIT T OOPERATE STATE ID NUMBER 00000005987002 <br /> ( l OI NEW PERMIT UNDERGROUND <br /> } 02 CONDITIONAL PERMIT ( ) 05 RENEWED PERMIT STORAGE TAN K <br /> f ) CLOSED17 TAW ( ) 09 DELETE FROM FILE (NO FEEL <br /> Q6 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SUPCHARGE) <br /> I <br /> OWNER <br /> NAME(CORF TION,INOIVIDUAL OR <br /> GEO IHAS PUBLIC AGENCY) <br /> STREET ADDPESs ; ^� PUBLIC AGENCY ONLY <br /> 2460 E. MAIN STR. [ ) OI FED [ ) 02 STATE (:�j 03 LOCAL <br /> CITY <br /> I I <br /> FACILITY STOCKTON STATE zip <br /> CA 95205 <br /> FACILITY NAME <br /> GOLDEN STAR LIQUORS <br /> STREET AODP,ESS DEALER/FOREMAN/SUPERVISOR <br /> ABDUL GHAFOOR <br /> 2460 EAST MAIN STR <br /> CITY NEAREST CROSS STREET <br /> FILBERT <br /> STOCKTON <br /> eouNTY <br /> MAILING ADOPESS SAN JOAQUIN ZIP <br /> 2460 E. MAIN STR. CITY 95205 <br /> PHONE W/APEA COLE STOCKTON STATE ZIP <br /> 209-463-5149 TYPE OF BUSINESS CA 95205 <br /> NUMBER OF CONTAINERS (X) 01 GASOLINE STATION ( ) 02 OTHER <br /> 2 PUPAL APEAS ONLY : TOWNS'HIP <br /> RANGE <br /> IV ,/�/J SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> a <br /> DAYS: ni_.WsrL,:ST NAME FIPST) .AND PHONE W/.qRE <br /> GARCHA S. SURINOER PHONE <br /> A CODE NIGHTS; NAME <br /> (LAST NAME FIRST) AND PHONE W/AREA CODE <br /> C <br /> 2 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH ACH <br /> IV DESCRIPTION CONTAINER <br /> A. (X) 01 TANK ( J 04 OTHER: <br /> CONTAINER NUMBER 1 <br /> 3. MANUFACTURER (IF APFRCPPIATE): <br /> YEAR MFG: C. YEAR INSTALLED <br /> (x) UNKNOWN <br />). CONTAINER CAPACITY: 0 GALLONS ( } UNKNOWN E. DOES THE CONTAINER STORE: f } 01 WASTE <br />'. <br /> DOES THE CONTAINER STORE MOTOR VEHICL€ FUEL OR WASTE OIL ? fX) 02 PRODUCT <br /> NO <br /> (X) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM [ ) 04 DIESEL O( )E05 WASTE2OILL IF <br /> 06SOTHERK APPROPRIATE 8f)X(ES): <br /> CONTAINER CONSTRUCTION <br /> THICf;NESs OF PRIMARY CONTAINMENT: 1!4 ( ) GAUGE (}[} INCHES ( ) CM ( ) UNKNOWN <br />--� <br /> ( ) <br /> 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( ) 02 NON-VAULTED (X) 03 UNKNOWN <br /> f ) <br /> 01 DOUBLE WALLED (X) 02 SINGLE WALLED [ J 03 LINED <br />(X) 01 CAR50N STEEL i ) 02 STAINLESS STEEL [ ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE f ) 05 CONCRETE <br /> ( ) Ob ALUMINUM f ) 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMP05ITE i ) 10 NON-METALLIC <br />( J 12 UNKNOWN ( 1 13 OTHER <br /> F4-11MB 1191181851 <br /> PAGE 1 <br />