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STATE ID NUMBER 00000058690001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> (.)dj1 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED t l 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( 1 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NA:M=(COPPOPATICN.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> STOCKTON UNIFIED SCHOOL DISTRIC ( ) 01 FED ( ) 02 STATE 03 LOCAL <br /> STPEET 4C0PESS CITY STATE ZIP <br /> 701 NORTH MADISON ST. STOCKTON CA 95202 <br /> II FACILITY ,ICy� �" <br /> FACILITY N4.ME :sas0 Lpt�pOr-43(%0r%, yG�,tl'Q� CEALER:'FCREM.AN/SUPERVISOR <br /> BILL RUSSELL, DIRECTOR NL0.iK (LY<Ce <br /> STPEET ACDPESS NEAREST CROSS STREET <br /> 1932 EL PINAL ALPINE <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95205 <br /> MvILIN3 ADDRESS CITY STATE ZIP <br /> 1932 EL PINAL STOCKTON CA 95205 <br /> PHCNE W/.APEA CODE TYPE OF BUSINESS 1/ <br /> 209-944-4078 ( ) 01 GASOLINE STATION j,16 02 OTHER <br /> NU,-.BEP OF CONT.AINEPS PUPAL AREAS ONLY . fOWNSHIP RANGE SECTION <br /> 9 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME( LA.ST NAME FIRST) AND PHONE W/APEA CODE NIGHTS: N.AME(LAST NAME FIRST) AND PHONE W.'.APE.A CODE <br /> RUSSELL, B. 209-944-4078 SAME .205 -9ry- 1/07-V <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 1977 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 12000 GALLONS ( ) 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 BOX(ES): <br /> II ( ) 01 UNLEADED (X) 02 REGULAR ( ) 03 PREMIUM ( l 04 DIESEL ( ) 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( 1 GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> B. ( l 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( l 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( l 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> f ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />