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STATE ID NUMBER 00000063692002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( 1 01 NEW PERMIT l ) 05 RENEWED PERMIT (,x rt?-tAlRf•{,LOSFj) ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( l 06 AMENDED PERMIT l ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COPPCPATION,INOIVIOUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> DOPACO CALIFORNIA, INC. ( ) 01 FED ( 1 02 STATE f 1 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 800 A WEST CHURCH STREET STOCKTON CA 95203 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> DOPACO CALIFORNIA, INC. <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 600 A WEST CHURCH STREET <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95203 <br /> MAILING ADDRESS CITYSTATE ZIP <br /> 1899 W. MARCH LANE, SUITE B STOCKTON CA 95207 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-473-1033 ( ) 01 GASOLINE STATION (X) 02 OTHER CARTON CONVERTING <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 4 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTY: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> CHRISTIE, RAY 209-473-1033 SAME - - <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 82 (I.P.AC <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: GALLONS IX) UNKNOWN E. DOES THE CONTAINER STORE: l ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? f ) 01 YES (X) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( I <br /> 01 UNLEADED ( ) 02 REGULAR ( 1 03 PREMIUM ( ) 04 DIESEL f ) 05 WASTE OIL f ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE f ) INCHES f 1 CM (X) UNKNOWN <br /> S. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( 1 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED ( 1 03 LINED <br /> D. l ) 01 CARBON STEEL ( l 02 STAINLESS STEEL ( l 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE [ 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ] 08 BRONZE ( 109 COMPOSITE f ) 10 NON-METALLIC <br /> (X) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> 1d �/ <br />