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will <br /> 4 <br /> STATE ID NUMBER 00000066376001 <br /> APPLICATION FOR PERMIT TO OPERA E UNDERGROUND STORAGE TANK <br /> ( ) 01 NEW PERMIT f 1 05 RENEWED PERMIT 07 TANK CLOSED 09 DELETE FROM FILE tN0 FEE) <br /> ( ) 02 CONDITIONAL PERMIT t ) 06 AMENDED PERMIT T08 MINOR CHANGE (NO SURCHARGE <br /> I OWNER <br /> NAME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> UNIVERSITY OF THE PACIFIC ( ) 01 FED ( ) 02 STATE ( 1 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 1081 W. MENDOCINO STOCKTON CA 95211 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> UOP - PHYSICAL PLANT CHARLES AHRENS9 SUPT. CUS., GR <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 1081 W. MENDOCINO <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95211 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 1031 W. MENDOCINO STOCKTON CA 95211 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-946-2541 ( ) 01 GASOLINE STATION (X) 02 OTHER UNIVERSITY <br /> NUMBER OF CONTAINERS RURAL AREAS ONLYTOWNSHIP RANGE SECTION <br /> 2 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHCNE W/AREA CODE <br /> CHARLES AHRENS 209-946-2541 PUBLIC SAFETY 209-946-2535 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK C ) 04 OTHER= CONTAINER NUMBER 91 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG:= <br /> YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 500 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: (X) 01 WASTE ( l 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? t ) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( l 04 DIESEL ( 3 05 WASTE OIL i ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: X ( l GAUGE (X) INCHES C 1 CM ( 1 UNKNOWN <br /> B. l ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED ( 1 03 LINED <br /> D. f 1 01 CARBON STEEL f ) 02 STAINLESS STEEL i ) 03 FIBERGLASS i l 04 POLYVINYL CHLORIDE C ) 05 CONCRETE <br /> ( ) 06 ALUMINUM i 1 07 STEEL CLAD f ) 08 BRONZE ( 1 09 COMPOSITE t ) 10 NON-METALLIC <br /> (X) 12 UNKNOWN ( ) 13 OTHER: <br /> . HSC04-070185 (08/29/86) PAGE I <br />