Laserfiche WebLink
STATE ID NUMBER 00000009875003 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> 01 NEW PERMIT ( ) 05 RENEWED PERMIT l 1 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> 1 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT [ 1 08 MINOR CHANGE (NO SURCHARGE) <br /> OWNER <br /> .'.(COPPOPATION.:NDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> Y ELAM ( ) 01 FED ( ) 02 STATE ( 1 03 LOCAL <br /> :TP'.'-T ADDP!SS CITY STATE ZIP <br /> s966 S MCHENRY AVE ESCALON CA 95320 <br /> I FACILITY <br /> VILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> NDLY CHEVROLET ROY ELAM <br /> ;T REST AOOaESS NEAREST CROSS STREET <br /> X996 S. MCHENRY AVE KATHERINE WAY <br /> TY COUNTY ZIP <br /> CALON SAN JOAQUIN 95320 <br /> FILINO ADDRESS CITY STATE ZIP <br /> 96 S MCHENRY AVE ESCALON CA 95320 <br /> 'HO4E W/AREA CODE TYPEOF BUSINESS <br /> X09-838-7351 ( ) 01 GASOLINE STATION (X) 02 OTHER <br /> M5EP OK CONTAIN!PS PUPAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 3 <br /> 24 HOUR EMERGENCY CONTACT PERSON <br /> JAYS NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS NAME(LAST NAME FIFST) AND PHONE W/AREA CODE <br /> ELAM, ROY 209-838-7351 209-838-7167 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> V DESCRIPTION <br /> A (X1 01 TANK ( ) 04 OTHER CONTAINER NUMBER I <br /> MANUFACTURER (IF APPROPRIATE) MOWELCO YEAR MFG :19615C YEAR INSTALLED 1965 ( 1 UNKNOWN <br /> UCONTAINER CAPACITY 1000 GALLONS ( 1 UNKNOWN I E DOES THE CONTAINER STORE I ) 01 WASTE (X) 02 PRODUCT <br /> DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ' (X) 01 YES 1 ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> (XI 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM l 1 04 DIESEL t ) 05 WASTE OIL ( ) 06 OTHER <br /> CONTAINER CONSTRUCTION <br /> THICKNESS OF PRIMARY CONTAINMENT 12 1X1 GAUGE ( ) INCHES ( ) CM I ) UNKNOWN <br /> q—( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON—VAULTED ( ) 03 UNKNOWN <br /> ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( 1 03 LINEO <br /> X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( l 05 CONCRETE <br /> ( ) 06 ALUMINUM t 1 07 STEEL CLAD ( l 08 BRONZE ( 1 09 COMPOSITE [ ) 10 NON—METALLIC <br /> ( 1 12 UNKNOWN ( ) 13 OTHER <br /> C04-070185 (10/18/85) PAGE 1 <br />