Laserfiche WebLink
STATE ID NUMBER 00000024100003 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> t l 01 NEW PERM=IT t } 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 0:9 DELETE FROM FILE (NO f£E) <br /> t ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION,INDIVIOUAI OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> EXXON COMPANY U.S.A. ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> __j <br /> STREET ADDRESS CITY FSTTXI <br /> TE ZIP <br /> 16945 NORTHCHASE BLVD/ HOUSTON 77210 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> EXXON SERVICE STATION MICHAEL D. COVEY <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 2705 COUNTRY CLUB BLVD. <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95204 <br /> MAILING ADDRESS CITY STATE ZZP <br /> 2705 COUNTRY CLUB BLVD. STOCKTON TX 95204 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-465-3042 (X) 01 GASOLINE STATION t ) 02 OTHER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSN%P RANGE SECTION <br /> 4 <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 /> HOFFMAN, S.D. 415-937-2991 OFFMAN, S.D. 415-372-3361 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION` <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 3 <br /> B. MANUFACTURER (IF APPROPRIATE): UNKNOWN YEAR MFG: 1970 C. YEAR INSTALLED 1970 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 6000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) ,01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 61 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: ( ) GAUGE ( ) INCHES (.J CM: (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> i <br /> C. ( ) 01 DOUBLE WALLED W 02 SINGLE WALLED { ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS t ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> t ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( l 09 COMPOSITE ( ) 10 METALLIC <br /> 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />