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STATE IO NUMBER 00000028637001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( O1 NEN PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> ITIONAL PERMIT f ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> SAN JOAQUIN COUNTY. DEPARTMENT ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS _ CITY STATE ZIP <br /> 5000 S. AIRPORT WAY STOCKTON CA 95206 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SVPERVISOR q ' <br /> STOCKTON METROPOLITAN AIRPORT GEORGE L. SP ORE <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 5000 S. AIRPORT WAY ARCH ROAD <br /> CITY COUNTY ZIP <br /> STOCKTON - SAN JOAQUIN 95206 <br /> MAILING ADDRESS CITYSTATE ZIP <br /> 5000 S. AIRPORT WAY STOCKTON CA 95206 <br /> PHONE W/APEA CODE TYPE OF BUSINESS ,L <br /> 209-982-4270 ( 1 01 GASOLINE STATION (X) 02 OTHER G6lff—VEM iC S-;�Eb 'v(r'tvrl <br /> NUMBExR OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/ARF,A CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> AIRPORT OPERATIONS 209-982-0313 AIRPORT OPERATIONS 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 16 <br /> S. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 500 GALLONS ( ] UNKNOWN E. DOES THE CONTAINER STORE: f ) 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 BOX(ES): <br /> ( ) 01 UNLEADED (X) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( 1 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> B. f l 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED 02 SINGLE WALLED ( ) 03 LINED <br /> D. f l 01 CARBON STEEL ( 1 02 STAINLESS STEEL ( ) 03 FIBERGLASS f ) 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( l 07 STEEL CLAD ( 1 08 BRONZE f ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> (X) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />