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AjK Z6fo UlFbj. <br /> Soo <br /> STATE ID NUMBER 00000013964001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> f l <br /> 01 NEW PERMIT ( ) 05 RENEWED PERMIT 07 TANK rinsm ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITICNAL PERMIT ( ] 06 AMENDED PERMIT } 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CO=PO=ATION,INJIVl0UAL OR PUBLIC AGENCY) FPUBLIC AGENCY ONLY <br /> SOUZA'S gUALITY MEATS ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET AC7RESS CITY CA 95376 <br /> STATE IIP <br /> 340 W. GRANTLINE RD. TRACY <br /> II FACILITY <br /> FACILITY NAME DEALER/FCREMAN/SUPERVISCR <br /> SCUZA'S QUALITY MEATS ANTHONY F. SOUZA, PARTNER <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 340 W. GRANTLINE RD PARKER AVE <br /> CITY =JOAQUIN <br /> IIP <br /> TRACY 95376 <br /> MAILING ADDRESS CITY STATE=TP340 W. GRANTLINE RD TRACY CA <br /> ;140N'S W/AREA CODE TYPE OF BUSINESS <br /> 209-835-8330 ( ) 01 GASOLINE STATION (X) 02 OTHER WHOLESALE MEAT CO. <br /> NUY.BER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> f _ <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> Fs <br /> AYS: NAME(LAST NAME FIRST) ANO PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> CUZA, A. F 209-835-8330 SOUZA, A. F. 209-835-6404 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER ONE <br /> B. MANUFACTURER (IF APPROPRIATE): UNKNOWN YEAR MFG: C. YEAR INSTALLED 1968 ( l UNKNOWN <br /> D. CONTAINER CAPACITY: 2000 GALLONS ( ) UNKNOWN JE. 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 /> (X) 01 UNLEADED f ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( ) 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( } GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( ) 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED t ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( l 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> t ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> [ ) 12 UNKNOWN f } 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />