Laserfiche WebLink
�� <br />[' <br />mrATs zo Mmnesn <br />. ^ <br />APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br />QQQ 01 NEW PERMIT I ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br />02 CONDITIONAL PERMIT ) 06 AMENDED PERMIT ( ) 04 MINOR CHANGE (NO SURCHARGE) <br />I OWNER <br />NAME(COPPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br />01 FED 02 STATE 03 LOCAL <br />Regal Stations, Inc. <br />STREET ADDRESS CITY STATE ZIP <br />1765 Challenge Way Sacramento lCa. 195815 <br />II FACILITY <br />FACILITY NAME <br />( x) 01 TANK <br />DEALER/FOREMEN/SUPERVISOR <br />Regal Station #605 <br />) CM ( ) UNKNOWN <br />Vlalt Snelling <br />STREET AODPESS <br />VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 <br />NEAREST CROSS STREET <br />1605 S. El Dorado <br />C. <br />Center STreet <br />CxYtockton <br />B. <br />cOYaTnY Joaquin <br />ZIP 96206 <br />MAILING ADDRESS <br />YEAR MFG: UN <br />CITY <br />STATE <br />lCa. <br />ZIP <br />1 <br />1765 Challenge Way <br />Sacramento <br />95815 <br />PHONE W/ACEA CODE JEUX": <br />TYPE CF BUSINESS <br />91,,6-921-1100 <br />(X) 01 GASOLINE STATION .02 OTHER <br />_�_7PUPAL <br />NUMBER OF CONTAINERS <br />AREAS ONLY <br />TOWNSHIP <br />RANGE <br />SECTION <br />three <br />III 24 HOUR EMERGENCY CONTACT PERSON <br />AYS: NAME(LAST NAME FIRST) AND PHONE W/APEA CODE TS: NAME(LAST NAME FIRST) AND PHONE W/APEA CODE <br />91-6-991-1100 Maintenance Dept 1-800-952-5324 <br />COMPLETE THE FOLLOWING ON 4 SEPARATE FORM FOR EACH CONTAINER <br />IV DESCRIPTION <br />A. <br />( x) 01 TANK <br />( ) GAUGE <br />02 OTHER: <br />) CM ( ) UNKNOWN <br />CONTA NER NUMBER 605�Rl <br />( 01 <br />VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 <br />NON -VAULTED ( <br />) 03 UNKNOWN <br />C. <br />( 01 <br />DOUBLE WALLED ()d 02 SINGLE WALLED <br />B. <br />MANUFACTURER <br />(IF <br />APPROPRIATE): Unknown <br />YEAR MFG: UN <br />I C. YEAR INSTALLED (x) UNKNOWN <br />09. CONTAINER CAPACITY: 10,000 GALLONS UNKNOWN I E. DOES THE CONTAINER STORE: 01 WASTE (XI 02 PRODUCT <br />F. DOES TH CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? ( ) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br />01 UNLEADED fx ) 02 REGULAR 03 PREMIUM 04 DIESEL 05 WASTE OIL 06 OTHER <br />V CONTAINER CONSTRUCTION <br />A. <br />THICKNESS OF PRIMARY CONTAINMENT: 1/4 <br />( ) GAUGE <br />(XI INCHES ( <br />) CM ( ) UNKNOWN <br />B. <br />( 01 <br />VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 <br />NON -VAULTED ( <br />) 03 UNKNOWN <br />C. <br />( 01 <br />DOUBLE WALLED ()d 02 SINGLE WALLED <br />03 LINEO <br />D. <br />(x) 01 <br />) <br />12 <br />CARBON STEEL 02 STAINLESS STEEL <br />06 ALUMINUM 07 STEEL CLAD 08 <br />UNKNOWN ( ) 13 OTHER: <br />03 FIBERGLASS 04 <br />BRONZE 09 COMPOSITE <br />POLYVINYL CHLORIDE 05 CONCRETE <br />10 NON-METALLIC <br />