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STATE ID NUMBER <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> (X ) 01 NEW PERMIT t ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> ' ( ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 0& MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COP PCRATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> Regal Stations, Inc. ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET A07^PESS CITY STATE J815 <br /> 1765 Challenge Way Sacramento Ca. 7J <br /> II FACILITY <br /> FACILITY N4ME DEALER/FOREMEN/SUPERVISOR. <br /> Regal Station #605 Walt Snelling <br /> S- <br /> 'BEET ACC=ESS NEAREST CROSS STP.EET p <br />� 1605 S. E1 Dorado Center Street <br /> CITgtockton CCU Wan Joaquin ZIP 206 <br /> MAULING ACDPESS CZ TY STATE ZIP <br /> 1765 Challenge Way Sacramento C . 95815 <br /> PHONE W%A=EA CODE �T►4T1o(� TYPE OF BUSINESS <br /> 916-921-11000. 01 GASOLINE STATION ( ) 02 OTHER <br /> —] <br /> NUMBER CF CONTAINEP.S RURAL AREAS ONLY : TOWNSHIP RANGE SECTION <br /> three <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 /> 916-921-1100 OC Main enan - - -5324 <br /> COMP ETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (f x) 01 TANK f l 02 OTHER: CONTAINER NUMBER 605-P1 ` <br /> B. MANUFACTURER (IF APPROPRIATE): Unknown YEAR MFG:UN C. YEAR INSTALLED (x) UNKNOWN <br /> D. CONTAINER CAPACITY: 10a NiCNDWTi 000 GALLONS ( 3 UE' ^uOES THE CONTAINER STORE t ) 01 WASTE (X) 02 PRODUCT <br /> _ <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? ( ) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ESI: <br /> t ) 01 UNILEADED ( D 02 REGULAR t ) 03 PREMIUM ( ) 04 DIESEL ( D 05 WASTE OIL (x) 06 OTHERPremium Unleaded <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 1/4 ( ) GAUGE tx:A INCHES t D CM t ) UNKNOWN <br /> 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. (x$ 01 CARBON STEEL ( D 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) OE ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE ( D 10 NON-METALLIC <br /> t ) 12 UNKNOWN ( ) 13 OTHER: <br /> )iSC04-0I0155 PAGE 1 <br />