COMPLIANCE INFO_2002-2008 - Laserfiche WebLink

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7 �9 TANKS UNDERGROUND STORAGE TANKS - FACILITY Qy (one page pe ) Page of TYPE OF ACTION ❑ 1. NEW SITE PERMIT ❑ 3. RENEWAL PERMIT ® 5.CHANGE OF INFORMATION ❑ TPERMANENTLY CLOSED SITE (Check one item only) ❑ 4. AMENDED PERMIT specify change local use only ❑ 8. TANK REMOVED ❑ &TEMPORARY SITE CLOSURE 400 BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 FAGtL)TY ID# Tesoro #67078 .35 N, d ' NEAREST CROSS STREET y5a yU 401 FACILITY OWNER TYPE ❑ 4. LOCAL GENCY/DISTRICT* ® 1. CORPORATION ❑ 5. COUNTY AGENCY* BUSINESS ® 1. GAS STATION ❑ 3. FARM ❑ 5. COMMERCIAL ❑ 2. INDIVIDUAL ❑ 6. STATE AGENCY* TYPE ❑ 2. DISTRIBUTOR ❑ 4. PROCESSOR ❑ 6. OTHER 403 ❑ 3. PARTNERSHIP ❑ 7. FEDERAL AGENCY* 402 TOTAL NUMBER OF TANKS Is facility on Indian Reservation or *If owner of UST is a public agency: name of supervisor of division, section or office REMAINING AT SITE trustlands? which operates the UST (This is the contact person for the tank records.) 3 404 ❑ Yes ® No 405 406 PROPERTY OWNER NAME 407 PHONE 408 Tesoro Refining and Marketing Co. 253-896-8700 MAILING OR STREET ADDRESS 409 3450S.344 th Way Suite 100 CITY 410 STATE 411 ZIP CODE 412 Auburn WA 98001-5931 PROPERTY OWNER TYPE ®1. CORPORATION ❑ 2. INDIVIDUAL ❑ 4. LOCAL AGENCY / DISTRICT ❑ 6. STATE AGENCY ❑ 3. PARTNERSHIP ❑ 5. COUNTY AGENCY ❑ 7. FEDERAL 413 TANK OWNER NAME 414 rflvlvt 415 Tesoro Refining and Marketing Co. 253-896-8700 MAILING OR STREET ADDRESS 416 3450S.344 th Way Suite 100 CITY 417 1 STATE 418 ZIP CODE 419 Auburn WA 98001-5931 TANK OWNER TYPE ® 1. CORPORATION [:12. INDIVIDUAL [14. LOCAL AGENCY / DISTRICT ❑ 6. STATE AGENCY 420 [13. PARTNERSHIP [:15. COUNTY AGENCY [17. FEDERAL AGENCY NAME OF'APPLICANT (print) 42e TITLE OF ANNLICAN I vzl Robert E. Hoover Retail Environmental Administrator STATE UST FACILITY NUMBER (For local use only) 428 1998 UPGRADE CERTIFICATE NUMBER (For local use only) 429 J . '-D 9'4 90 UPCF (1/99 revised) Formerly SWRCB Form A