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Dwe (4ic 40 STATE ID <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGENTANK <br /> o0000o1974zool <br /> ( ) 01 NEW PERMIT ( J 05 RENEWED PERMIT (f) n� ...�., 1DSF0 <br /> 1 ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT (. ) OB MINA— R E (ryp SURCHARGE) 09 DELETE FROM FILE (NO FEEL <br /> I OWNER <br /> NAME(COPPORATION,INDIVIDUAL OR PUBLIC AGENCY) <br /> E.F.MITCHLER CO. PUBLIC AGENCY ONLY <br /> STREET ADDRESS ( ) O1 FED ( ) 02 STATE ( ) 03 LOCAL <br /> 400 S LINCOLN STREET CITY <br /> STOCK TON STATE IIP <br /> CA 95203 <br /> II FACILITY <br /> FACILITY NAME <br /> VALLEY WELDING DEALER/FOREMAN/SUPERVISOR <br /> STREET ADDRESS <br /> 1030 N UNION ST NEAREST CROSS STREET <br /> CITY ACACIA <br /> STOCKTON COUNTY <br /> SAN JOAQUIN IIP <br /> MAILING ADDRESS 95205 <br /> 1030 N UNION. ST CITY <br /> STOCKTON STATE IIP <br /> PHONE W/AREA CODE CA 95205 <br /> 209-465-5684 TYPE OF BUSINESS <br /> ( ) 01 GASOLINE STATION (X) 02 OTHER <br /> NUMBER OF CONTAINERS <br /> 2 RURAL AREAS ONLY TOWNSHIP <br /> RANGE SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> .DAYS: N4^E(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> K L <br /> EIN. ROBERT T209-466-8941 NIGHTS: NAMEf LAST NAME FIRST) AND PHONE W/AREA CODE <br /> KLEIN. ROBERT 209-478-5528 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: <br /> CONTAINER NUMBER 5 <br /> B. MANUFACTURER (IF APPROPRIATE): <br /> YEAR MFG: C. YEAR INSTALLED <br /> (X) UNKNOWN <br /> D. CONTAINER CAPACITY: GALLONS (X) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE ( ) 02 PRODUCT <br /> THE <br /> MOTOR <br /> F. ( 1 01 UNLEADED <br /> NER STORE0R EGULARVEHI'L03FPREMIUM UEL OR WASTE U4 LDIESEL ( ) 05 WASTE OIL ( 7 O6 OTHER <br /> ( 1 O1 YES (AS 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: f ) GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( ) 02 NON-VAULTED (X) 03 UNKNOWN <br /> C• ( ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED ( ). 03 LINED <br /> D• ( ) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS f ) 04 POLYVINYL CHLORIDE ( 7 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( 1 08 BRONZE ( ) 09 COMPOSITE ( ] 10 NON-METALLIC <br /> (X) 12 UNKNOWN ( J 13 OTHER: <br /> 3C04-070185 (10/18/85) <br /> PAGE 1 <br />