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STATE ID NUMBER 00000065391003 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED l ) 09 DELETE FROM FILE (NO FEE) <br /> ( 1 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> SHINKO ELECTRIC AMERICA: INC. ( ) 01 FED ( ) 02 STATE f 1 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 4701 PATRICK HENRY DRIVE,-Bt�G�j � f�G){ SANTA CLARA CA 95054 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOPEMAN/SUR RVISOR <br /> SHINKO ELECTRIC AMERICA, INC. iHEBB,kYkShRI l <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 551 CARNEGIE STREET <br /> CITY COUNTY ZIP <br /> MANTECA SAN JOAQUIN 95336 <br /> MAILING ADDRESS CITY STATE ZIP <br /> P.O. BOX 1208 MANTECA CA 95336 <br /> PHONE W/AREA CODE TYPEOF BUSINESS <br /> 209-239-6559 ( 1 01 GASOLINE STATION (X) 02 OTHER MANUFACTURING 6CO/4&jCMr�- <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY I�WN HIP RANGE SECTION <br /> A6 7 <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 /> BUETTNER, BILL 209-239-6559 BUETTNER, BILL 209-524-9809 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER= CONTAINER NUMBER T-17 <br /> B. MANUFACTURER (IF APPROPRIATE): TANKIN€TECS YEAR MFG: 1984 C. YEAR INSTALLED 1984 4 1 UNKNOWN <br /> D. CONTAINER CAPACITY 564 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: t ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? ( ) 01 YES (X) 02 NO IF YES CHECK APPROPRIATE BOX(ES)- <br /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM i 1 04 DIESEL ( ) 05 WASTE OIL 06 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT= 1/4 ( l GAUGE (X) INCHES ( ) CM ( ) UNKNOWN <br /> B. (X) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( ) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED t 1 03 LINED <br /> D. ( ) 01 CARBON STEEL ( 1 02 STAINLESS STEEL ( 1 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM { ) 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE { 1 10 NON-METALLIC <br /> ( ) 12 UNKNOWN (X) 13 OTHER: FR ( <br /> HSC04-070185 (05/05/86) PAGE 1 <br />