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STATE ID NUMBER 00000011082007 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ® ONITIONA ( 1 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEED <br /> ( 02 CDL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COPPOPATION,INCIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> WM H. RAMSEY ( ) 03 FED t ) 02 STATE t D 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 10501-E KIMBERLY MANTECA CA 95336 <br /> II. FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> FRANK'S EXXON #3 FRANK GUINTA <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 4022 HWY 120 AIRPORT <br /> CITY COUNTY ZIP <br /> MANTECA SAN JOAQUIN 95336 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 4022 HWY 120 MANTECA CA 95336 <br /> 771 1 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-239-9575 (X) 01 GASOLINE STATION [ ) 02 OTHER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION' <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 /> W.H. RAMSEY 209-239-9571 RAMSEY, W.H. 209-823-1884 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK t ) 04 OTHER: CONTAINER NUMBER 7 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: 197YEAR INSTALLED 1979 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 2000 GALLONS ( ) UNKNOWN JE. DOES THE CONTAINER STORE: IX) 01 WASTE ( ) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE SOX(ES): <br /> ( ) 01 UNLEADED ( ) 02 REGULAR { D 03 PREMIUM ( ) 04 DIESEL (X) 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 1/4' f ) GAUGE (X) INCHES ( ) CM ( ) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( D 03 LINED <br /> 0. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL t ) 03 FIBERGLASS ( D 04 POLYVINYL CHLORIDE t D 05 CONCRETE <br /> ( ) 06 ALUMINUM (- D 07 STEEL CLAD t ) 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( 1 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />