Laserfiche WebLink
• STATE ID NUMBER 00000000725003 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( 1 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( l 09 DELETE FROM FILE (NO FEE) <br /> 02 CONDITIONAL PERMIT ( l 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COP.PORAT N,INOIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> pk R Pcz A 01 FED ( ) 02 STATE 03 LOCAL <br /> STREET ADDRESS / CITY STATE ZIP <br /> i$3 /✓. M�',�ll/ B A MTS cA <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 ADDRESS �'� CITY STATE ZIP <br /> N , 8ouw CA 95336 <br /> PHONE W/ARE CODE 'F/7" TYPE OF BUSINESS <br /> 46 (X) 01 GASOLINE STATION f ) 02 OTHER <br /> NUMBER, OF CCNTAINEP.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 NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> �- z?g <br /> �MPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 7 <br /> B. MANUFACTURER (IF APPROPRIATE): PERKINS YEAR MFG: 1965 C. YEAR INSTALLED 1965 t ) 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 /> ( ) 01 UNLEADED ( ) 02 REGULAR (X) 03 PREMIUM ( ) 04 DIESEL ( ) 05 WASTE OIL ( ) 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 ( l 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />