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• STATE ID NUMBER 00000000725002 <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 /> ( ) 02 CONDITIONAL PERMIT ( l 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> Cry R A o Z A- ( ) 01 FED ( l 02 STATE 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP '. <br /> ----------------------- <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> `FRANK'S EXXON #1 FRANK GUINTA <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 290 N. MAIN ST <br /> CITY COUNTY ZIP <br /> MANTECA SAN JOAQUIN <br /> MAILING ADOPESS CITY STATE ZIP <br /> !Y /_ ( <br /> ^� n .� .__..: CA 95336 <br /> PHONE W/AREA CODE TYPE OF BUSINESS , / <br /> 209-239-2446 (X) 01 GASOLINE STATION ( ) 02 OTHER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY : FNSMIP RANGE SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W ODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> � S `71 — - <br /> �r r �R-" c <br /> LETE TkG FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> f A. (X) 01 TANK ( l 04 OTHER: CONTAINER NUMBER 6 <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: ( 1 01 WASTE (X) 02 PRODUCT <br /> FF. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) O1 YES ( l 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ) 01 UNLEADED (X) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( ) 05 WASTE OIL ( l 06 OTHER <br /> III V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 1/4 ( ) GAUGE (X) INCHES ( ) CM ( l 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 /> 0. (X) 01 CARBON STEEL ( l 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD t 1 08 BRONZE ( ) 09 COMPOSITE ( l 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />