Laserfiche WebLink
STATE ID NUMBER 00000062251001 <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 ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE NO SURCHARGE) <br /> I GWNER <br /> NAME(COP,PORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> CHEVRON U.S.A. INC. ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITY .STATE ZIP <br /> 575 MARKET SAN FRANCISCO CA 9410S <br /> II FACILITY <br /> FACILITY NAME � n DEALER/FOREMAN/SUPERVISOR <br /> ►`C.V roh GEIST,KEITH B <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 25650 HWY 99, NORTH NEAR COLLIER RD <br /> CITY COUNTY ZIP <br /> ACAMPO SAN JOAQUIN 95220- <br /> MAILING ADDP,ESS CITY FCA <br /> TE ZIP <br /> kl, [/h L°. lAe*mpe- �c�i "r -Ss.2 Yl� <br /> PHONE W/AREA CODE TYPE Of BUSINESS <br /> 209-333-1740 (X) 01 GASOLINE STATION ( ) 02 OTHER <br /> NUMBER Of CONTA:NEP.S RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 6 <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 /> MAINTENANCE DISPATCH 415-877-0244 - - <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 91 TANK ( ) 04 OTHER: CONTAINER NUMBER 1 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: 1971 C. YEAR INSTALLED 1971 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 10000 GALLONS ( ) UNKNOWN JE. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> "F. DOES THE CONTAINER STORE MOTOR VEHICLE FUELORWASTE OIL ? PC) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( ) 01 'UNLEADED CX) 02 REGULAR ( 1 03 PREMIUM ( ) 04 DIM ( ) 05 WASTE OIL ( l 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 0000250 ( ) GAUGE ( ) 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 [ ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( l 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM' ( ) 01 STEEL CLAD ( 1- 08 BRONZE t l 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />