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STATE ID NUMBER 00000035002010 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) 01 NEW PERMIT ( ) 05 RENEWED PERMIT (Cl Osvn ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT [ CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CCRPORATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> SAN JOAQUIN COUNTY -brPAR7T"eff— I( ) 01 FED ( ) 02 STATE ) 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP 9 sioz <br /> STOCKTON CA 9-06 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> STOCKTON METROPOLITAN AIRPORT GEORGE L. SPADAFORE( AIRPORT M x..0.9!r <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 5000 S. AIRPORT WAY ARCH ROAD <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95206 <br /> MAILING ADORE SSCITY STATE ZIP <br /> 5000 S. AIRPORT WAY STOCKTON CA 95206 <br /> PHONE W/AR'-A CODE TYPE OF BUSINESS /�11 <br /> 209-982-4270 ( ) 01 GASOLINE STATION (X) 02 OTHER .41;Pp01' <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) AND PHONE W/AREA CODE <br /> AIRPORT OPERATIONS OFFICE 209-982-0313 AIRPORT OPERATIONS OFFICE 209-982-0313 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 10 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 25000 GALLONS f ) UNKNOWN E. DOES THE CONTAINER STORE: l ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? VO 01 YES LXeO2 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( ) 05 WASTE OIL 00 06 OTHER /a/ &:S <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( 1 INCHES f ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) f 9 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (7qIN02 SINGLE WALLED ( ) 03 LINED <br /> D. ( ) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ] 03 FIBERGLASS f 1 04 POLYVINYL CHLORIDE ( ] 05 CONCRETE <br /> 1 ) 06 ALUMINUM ( 1 07 STEEL CLAD ( 1 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> (X) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />