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STATE ID NUMBER 00000009958001 <br /> • ORAGE TANK <br /> ST <br /> GROUND FROM FILE LNO FEE) <br /> P RATE UNDER ( ) Oq DELETE <br /> PERMIT TO <br /> 7 CL <br /> HARGEI <br /> N F OR 0TANK OSED tN0 SURO <br /> Ir pT I O RENEWED PERMIT ( 1 OS MINOR CHANGE <br /> 05RENEWED <br /> PERMIT LOCAL <br /> PUBLIC AGENCY ONLY <br /> IT RMI 1 02 STATE ( 1 0 <br /> t 01 NE P IONAL PE T t ) 01 FED l ZIP <br /> 02 Ca STATE 95202 <br /> CA <br /> IF I OWNER INOIVZOUAL OR PUDLIC AGENCY) STOCKTON <br /> N <br /> i— RATION' INC. <br /> NAME(CORPO <br /> VI VALLEY VOLKSWAGE <br /> , <br /> KESS UPERVISOR <br /> A. 647E ET MINER oREMAN/S <br /> DEALER/F <br /> JAY FRIEDMAN <br /> S. L II FACILITY NEAREST CROSS STREET <br /> ZIP <br /> (t STANISLAUS 95202 <br /> FACILITY NAME INC, <br /> VALLEY VOLKSWAGEN+ COUNTY ZIP <br /> V I I STATE 95201 <br /> ADDRESS SAN JO CA CA <br /> STREET MINER <br /> UH 0, 647 E cITY <br /> ( ) STOCKTON <br /> CITY AUTO DEALER <br /> U I I I ( STOCKTON ADDRESS BUSINESS t%l 02 OTHER SECTION <br /> IF YO MAILING ADD TYPE OF SOLINE STATION RANGE <br /> P.O, BOX 1929 ( ) O1 GA <br /> CURRENTLY <br /> REA CODE EAS ONLY TOWNSHIP <br /> STORED PHONE W/3821 RURAL AREA <br /> 209-466- AND PHONE W/AREA <br /> ( ) O1 CONTAINERS NAME FIRST) 1756 <br /> sums 0� PERSON 209'931' <br /> ( ) 01 CY CONTACT NIGHTS: NAME(IAST <br /> t ) of III 24 NOUR EMERGEN AND PHONE w%AREA coDE SAME EACH CONTAINER <br /> FIR STIyK'�{(p SEPARATE FORM FOR <br /> t ) 01 wE(LAST NAME 2p9' <br /> CA NAu JAY <br /> WING ON A <br /> FRIEDMAN� F0LL0 <br /> t ) Ol t E T E T H E CONTAINER NUMBER 1 <br /> t ) 01 ( COMPL <br /> DESCRIPTION C. YEAR INSTALLED <br /> t 7 01 ( IV YEAR MFG• <br /> t ) 04 OTHER, (X1 O1 W STE 1 <br /> r ) 01 r 7 A ('Al 01 TANK UNKNOWN DONT A. STORE 1F YES [HEC, <br />( 1 <br /> 01 ( ) OPRIATEY DOES THE NO OTHEF <br />( ) 01 f 1 0 B, MANUFACTURER lIF APPR GALLONS (�F'1 UNKNOWN E OIL ? (Xl 0`%)05 WASTE OIL t 1 06 <br /> N CHECK STATE BOA CAPACITY' <br /> S VEHICLE FUEL OR WASTE p4 DIESEL <br /> 0. CONTAINER STORE MOTOR ( ) 03 PREMIUM <br />- CONTAINER 02 REGULAR (Al UNKNOWN <br /> GOES THE t ) t ) CM <br /> i <br /> CONTAINER LOCATE[ F' l 1 O1 UNLEADED U CT I ON INCHES <br /> CONTAINER <br /> CONSTR ( ) GAUGE t ) 1i41 03 UMKNOWN <br />'S FORM HAS BEEN C \1 <br /> RSO FI ONATL INMENT ) 02 "ON-VAULTEO <br /> A. THICKNESS OF PRIMARY CONTA <br /> VAULTI <br /> AN UNDERGROUND <br /> R LOCAL AGENCY B. ( 1 O1 VAULTED <br /> ILOCATEO IN t ) 03 LINED 4 POLYVINYL CNnE <br /> SINGLE WALLED IBERGLASS t ) 0 t ) 10 NON- <br /> [. [ ) O1 0 WALLED (( )) OZ STAINLE p STEEL (BRONZE l ) 09 COMPOSITE <br /> 7INISTRATIN GENCY <br /> DOUBLE t l OB <br /> 5 STEEL t STEEL <br /> iTACT PE$SoN U t ) O1 CAR p�U111NUM )OTHER: <br /> t l 06 <br /> tX1 12 UNKNOWN t ) 13 <br /> E OF LAST INSPECTION II 070185 (10/18/851 <br /> t HSC04- <br /> �.-. PERMIT 20 # <br /> 9-070185 (10/18/85) - <br /> PAGE 2 <br /> 4R <br />