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STATE ID NUMBER 00000058851003 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> f l O1 N 1 ( 1 05 RENEWED PERMIT �) 07 TAW[ CLOSED ) 09 DELETE FROM FILE (NO FEE) <br /> ONDITI AL PERMIT ( ) 06 AMENDED PERMIT ] 08 MINOR CHANGE (NO SURCHAR <br /> I OWNER <br /> NAM.E(CCPPOP.ATICN,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> LISBEY-OWENS-FORD COMPANY ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 811 MADISON AVENUE, P.O. BOX 7 TOLEDO ON 43695 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> LATHROP PLANT 010 G. ROBERT MEYER <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 500 LOUISE AVENUE <br /> CITY COUNTY ZIP <br /> LATHROP SAN JOAQUIN 95330 <br /> MAILING ADDRESS CITY STATE ZIP <br /> P.O. BOX 128 LATHROP CA 95330 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-858-5151 ( ) 01 GASOLINE STATION (X) 02 OTHER GLASS MFG. <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 3 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W,/AREA CODE <br /> MOWERY, ROBERT 209-477-8459 MOWERY, ROBERT 209-477-8459 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 1 <br /> B. MANUFACTURER (IF APPROPRIATE)- YEAR MFG: C. YEAR INSTALLED 1982 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 5000 GALLONS ( 1 UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> F. ODES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 01 YES ( 1 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( ) 01 UNLEADED ) 02 REGULAR (0) 03 PREMIUM ( L 04 DIESEL ( 1 05 WASTE OIL ( l 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 10 (X) GAUGE ( l INCHES ( ) CM ( 1 UNKNOWN <br /> B. f ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( 1 02 SINGLE WALLED f ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL [ l 03 FIBERGLASS ( 7 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( 1 07 STEEL CLAD f ) 08 BRONZE ( l 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> 4 y <br />