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STATE ID NUMBER 00000000725001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ) 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> 4 <br /> T 2 CONDITIONAL PERMIT ( l 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPO INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> E Gtr-p O-ZA, ( l 01 FED ( ) 02 STATE 03 LOCAL <br /> STREET ADDRESS _ t CITY STATE ZIP `rs33 <br /> 6 ) I g3 N . M i/.� MTF - CA <br /> I <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> FRANK'S EXXON #1 FRANK GUINTA Tr <br /> I <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 290 N. MAIN ST <br /> CITY COUNTY ZIP <br /> MANTECA SAN JOAQUIN <br /> MAILING ADDRESS CITY 7 STATE <br /> CA <br /> PHONE W/AREA CODE TYPE OFBUSINESS <br /> 209-239-2446 (X) 01 GASOLINE STATION ( ) 02 OTHER <br /> NUMBER OF CONT iNEP.S RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHT$: NAME(LAST NAME 4rIP.ST) AND PHONE W/AREA CODE <br /> n/9 <br /> COMPLETE "E FOLLOWING ON A SEPARATE FO M FOR hCH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 5 <br /> B. MANUFACTURER (IF APPROPRIATE): PERKINS YEAR MFG: 1965 C. YEAR INSTALLED 1965 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 8000 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 ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL t ) 05 WASTE OIL ( l 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 1/4 ( ) 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 ( ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( 1 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ) 06 ALUMINUM ( l 07 STEEL CLAD { ) 08 BRONZE ( ) 09 COMPOSITE (. ) 10 NON-METALLIC <br /> { ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />