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• • STATE 10 NUMBER 00000060765001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> �1 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED ,�59 DELETE FROM FILE (NO FEE) <br /> (�l 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHAR EG 1 <br /> I OWNER <br /> NAME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) FPUBLIC AGENCY ONLY <br /> D'T^..... GO- 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS ,, // CITY J� (�J' STATE ZIP <br /> CA <br /> II FACILITY <br /> FACILITY NAME OEALER/FOREMAN/SUPERVISOR <br /> UNION OIL SS# 5417 JAMES J. MCCARTHY <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 1700 EAST YOSEMITE AVENUE HIGHWAY 99/HWY 120 <br /> CITY COUNTY ZIP <br /> MANTECA SAN JOAQUIN 95336 <br /> MAILINGi ADDRESS CITYSTATE ZZP <br /> 1ZS b CA �y <br /> PHONE W/AREA CODETYPE OF BUSINESS <br /> 209-�i9�434� a •��� (X) 01 GASOLINE STATION ( ) 02 OTHER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 1 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AP.EA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> JAURIGUI, L.J. 415-X56-7b60 (��� UNION OIL CO. 415-9f -13tr <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. ( l 01 TANK (X) 04 OTHER:' Swo CONTAINER NUMBER 5417-10-1 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: GALLONS (X) UNKNOWN E. DOES THE CONTAINER STORE: (X) 01 WASTE ( ) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? ( ) 01 YES (X) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( ) 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 6 ( ) 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 t ) 03 LINED <br /> D. ( ) 01 CARBON STEEL ( l 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE (X) 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 />