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STATE ID NUMBER 00000019674001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> (N 01 NEW PERMIT ( 1 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> �+y 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COP.PORATION.ZNDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> AGRI BIS INC l ) 01 FED ( ) 02 STATE f ) 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 1120 W CHARTER WAY STOCKTON CA 95206 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/S PERMS R <br /> MID CAL TRACTOR <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 1120 W CHARTER WAY ARGONAUT <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95206 <br /> MAILING ADDRESS CITYSTATE ZZP <br /> P.O. BOX 6069 STOCKTON CA 95206 <br /> PHONE W/AP.EA CODE TYPE OF BUSINESS <br /> 209-944-5714 ( ) 01 GASOLINE STATION (X) 02 OTHER EQUIP DEALER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAMEILAST NAME FIRST) AND PHONE W/AREA CODE NIGXTS: NAME(IAST NAME FIRST) AND PHONE W/AREA CODE <br /> (jMM'"BEORI'E` 209-944-5714 SIM-OEORpt 209-931-4836 <br /> -CDWTE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 101 <br /> S. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED 1976 f 1 UNKNOWN <br /> D. CONTAINER CAPACITY: 10000 GALLONS f ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X1 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) Ol YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES1: <br /> ( ) <br /> 01 UNLEADED f ) 02 REGULAR ( ) 03 PREMIUM (X) 04 DIESEL ( 1 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( 1 GAUGE f ) INCHES ( ) CM (X) UNKNOWN <br /> B. ( 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED f l 03 LINED <br /> 0. ( ) 01 CARBON STEEL ( 1 02 STAINLESS STEEL f 1 03 FIBERGLASS f 7 04 POLYVINYL CHLORIDE f ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( 1 08 BRONZE ( ) 09 COMPOSITE t ) 10 NON-METALLIC <br /> (X) 12 UNKNOWN t ) 13 OTHER: <br /> MSC04-070185 (10/18/85) PAGE 1 <br /> L � <br />