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STATE ID NUMBER 00000065391007 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ,01 NEW PERMIT ( 1 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( 1 09 DELETE FROM FILE F40 FEE) <br /> ( 1 02 CONDITIONAL PERMIT ( l 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. l } 01 FED f } 02 STATE 1 ) 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 4701 PATRICK HENRY DRIVE, T ,f70SANTA CLARA CA 95054 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> SHINKO ELECTRIC AMERICA, INC. �NFASFIi'l J <br /> STREET AODRESS NEAREST CROSS STREET <br /> 551 CARNEGIE STREET <br /> CITY COUNTY ZIP <br /> MANTECA SAN JOAQUIN 95336 <br /> MAILING ADDRESS CITY SATE ZIP <br /> P.O. BOX 1208 MANTECA ]CTA 95336 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-239-6559 ( ) 01 GASOLINE STATION (X) 02 OTHER MANUFACTURING G l C CQt/C76 <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA. CODE NIGHTS: NAME(LAST NAME FIRST) ANDPHONE 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 ( 1 04 OTHER: CONTAINER NUMBER T-21 <br /> B. MANUFACTURER (IF APPROPRIATE): POLY CAL PLASTIC YEAR MFG: 1984 C. YEAR INSTALLED 1984 l 1 UNKNOWN <br /> D. CONTAINER CAPACITY: 4000 GALLONS ( 1 UNKNOWN E. DOES THE CONTAINER STORE: (X) 01 WASTE ( 1 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 ( } 04 DIESEL f ) 05 WASTE OIL io 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT 1/4 ( ) GAUGE (X) INCHES ( ) CM ( ) UNKNOWN <br /> B. (X) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( 1 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED 4 ) 03 LINED <br /> D. ( 1 01 CARBON STEEL I ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE 1 l 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 06 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> l l 12 UNKNOWN (X) 13 OTHER: POLYETHYLENE <br /> HSC04-070185 (05/05/86) PAGE 1 <br />