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0 OSTATE ID NUMBER 00000031688002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> (`I) 01 NEW PERMIT f ) 05 RENEWED PERMIT ( 1 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> i ) 02 CONDITIONAL PERMIT i ) 06 AMENDED PERMIT ( 1 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> N.A'"E(CORPOPATION INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> 01 FED ( 1 02 STATE i ) 03 LOCAL <br /> STREET ADORESS CITY /� /Il�71�t,� t Tsc <br /> TATE ZIP <br /> f� Wi7u4a16 1943��-r <br /> 1 <br /> II FACILITY <br /> FACILITY NAME CEALEP./FOREMANISVP RVISOR <br /> UNION OIL SS# 0187 cif-�WArtTETF (// <br /> STREET ADOPESS NEAREST CROSS STREET <br /> 437 EAST MINER AVE. CALIFORNIA <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95202 <br /> MAILING ADDRESS CITY STATE ZIP <br /> a(7S/N / � > ZT4*ffCA max-?q <br /> pHCN= W/4PEA. CODE TYPE OF BUSINESS <br /> �a 'y (X) 01 GASOLINE STATION C ) 02 OTHER <br /> NOM.3ER OF CONTAINERS PUPAL AREAS ONLY FHIP RANGE SECTION <br /> 3 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NA1;E(LAST NAME FIRST) AND PHONE W/APEA CODE NIGHTS: NAME(LAST NAME FIPST) AND PHCNE W/AREA CODE <br /> JAURIGUI9 L.J. 415-9�i0-�C (t!' = UNION OIL 415-_`- -=�+"cc <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> I - <br /> A. (X) 01 TANK ( ) 04 OTHER= CONTAINER NUMBER -0-187-2-1- <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: 1967 C. YEAR INSTALLED 1967 S 1 UNKNOWN <br /> D. CONTAINER CAPACITY: ITFW-GALLONS C ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOXCES)= <br /> ( ) 01 UNLEADED ( ) 02 REGULAR (X) 03 PREMIUM i ] 04 DIESEL ( ) 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE i ] INCHES C ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( 1 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED 1 ) 03 LINED <br /> D. (X) 01 CARBON STEEL C 1 02 STAINLESS STEEL [ 1 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( 1 07 STEEL CLAD ( ) 08 BRONZE ( } 09 COMPOSITE ( ) 10 NON-METALLIC <br /> i ) 12 UNKNOWN ( ) 13 OTHER <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> 0 40 <br />