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NOW STATE ID NUMBER 00000008155002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ,�( 1 NEW PERMIT l 1 05 RENEWED PERMIT ( 1 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( ) C2 CONDITIONAL PERMIT f ) 06 AMENDED PERMIT ( 1 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NA MEI.^ORPOPATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> TIME OIL CO. <br /> ( ] O1 FED ( 1 02 STATE f ) 03 LOCAL <br /> I'"T ADDRESS CITY STATE ZIP <br /> X2737 14. COMMODORE WAY SEATTLE WA 98199 <br /> II FACILITY <br /> [FCK <br /> A^..LITY NAME DEALER/FOREMAN/SUPERVISOR <br /> J Al- VINCENT F. BLANK <br /> 45'fREET ADDRESS NEAREST CROSS STREET <br /> i4U1 S. CHEROKEE LANE LODI AVE. <br /> ~ COUNTY ZIP <br /> !`IL„TY SAN JOAQUIN 95240 <br /> (MAILING ADDRESS CITY / I STATE ZIP <br /> If+01 S. CHEROKEE LANE 11Ji- 95240 <br /> F <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-369-5624 (X) 01 GASOLINE STATION ( 1 02 OTHER <br /> ' DUMBER OF CONTAINERS RURAL AREAS ONLY : TOWNSHIP RANGE SECTION <br /> 3 <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 /> HIGNIGHT STEVEN C 916-423-1998 SAME - - <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> 1jA. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 412 <br /> B. MANUFACTURER (IF APPROPRIATE): BUTLER MFG. YEAR MFG: 1950 C. YEAR INSTALLED 1950 f 1 UNKNOWN <br /> D. CONTAINER CAPACITY: 10000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( 1 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOXIES): <br /> ( ) 01 UNLEADED (J�-I 02 REGULAR ( ) 03 PREMIUM ( 1 04 DIESEL ( ) 05 WASTE OIL 06 <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 1/4 f 1 GAUGE (X) INCHES ( ) CM ( 1 UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( l 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( 103 LINED <br /> D. (X) 01 CARBON STEEL f 1 02 STAINLESS STEEL ( 1 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> 1 ) 06 ALUMINUM ( 1 07 STEEL CLAD ( 1 08 BRONZE ( 1 09 COMPOSITE ( 1 10 NON-METALLIC <br /> 1 1 12 UNKNOWN f ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />