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STATE ID NUMBER 00000065592001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) 01 NEW PERMIT ( 1 05 RENEWED PERMIT Cl) 07 TANK CLOUD ( ) 09 DELETE FROM FILE (NO FEE) <br /> f 1 02 CONDITIONAL PERMIT f ) 06 AMENDED PERMIT l ) 08 MIND CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CDR PORATION,INDIVIDUAL OR PUBLIC AGENCY) Pl18 LIC AGENCY ONLY <br /> DOPACO CALIFORNIA. INC. ( ) O1 FEO ( ) 02 STATE f ) 03 LOCAL <br /> STREET ADDRESS CITY ST4TE 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 /> 800 A WEST CHURCH STREET <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95203 <br /> MAILING ADDRESS CITY STATE 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 /> NUMBEP. 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/ARCA CODE NIGHTS: 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 01 (TOLUOL <br /> B. MANUFACTURER (IF APPROPRIATE): �,y., YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> 0. CONTAINER CAPACITY: GALLONS m +UNKKNO(di E. DOES THE CONTAINER STORE: f 1 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 /> f ] 01 UNLEADED f ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL f ) 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE f ) INCHES ( ) CM (X) UNKNOWN <br /> B. f 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) t ) 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. f ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED ( 1 03 LINED <br /> D. f 1 01 CARBON STEEL f l 02 STAINLESS STEEL f 1 03 FIBERGLASS f 1 04 POLYVINYL CHLORIDE [ 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( 1 09 COMPOSITE ( 1 10 NON-METALLIC <br /> (XI 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> l <br />