Laserfiche WebLink
STATE ID NUMBER 00000024872002 <br /> APPLICATION FOR PERMIT TO OP ERGROUND STORAGE TANK <br /> ()() 01 NEW PERMIT l 1 05 RENEWED PERMIT07 TANK LOSER ( ) 09 DELETE FROM FILE (NO FEE) <br /> !•r 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT ( 1 E (NO SURCHARGE) <br /> I OWNER <br /> NAME(COPPOPATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> SAN JOAQUIN COUNTY MOSQUITO AS ( ) Ol FED ( ) 02 STATE OrY 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 5503 SOUTH AIRPORT WAY STOCKTON CA 95206 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> SAN JOAQUIN COUNTY MOSQUITO AB <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 5503 SOUTH AIRPORT WAY 'FiriKilc4mla Ed, <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95206 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 5503 SOUTH AIRPORT WAY STOCKTON CA 95206 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-982-4675 ( ) 01 GASOLINE STATION (X) 02 OTHER MOSQUITO ABATEMENT <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 6 <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 /> FIORI, JACK V. 209-982-4675 FIORI. JACK V. 209-368-9518 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( 1 04 OTHER: CONTAINER NUMBER NEB' <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED 1958 f ) UNKNOWN <br /> D. CONTAINER CAPACITY: 6000 GALLONS ( 1 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 /> f 1 01 UNLEADED (X) 02 REGULAR ( 1 03 PREMIUM ( ) 04 DIESEL ( 1 05 WASTE OIL f ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( 1 GAUGE ( ) INCHES ( l CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) f 1 02 NON—VAULTED (X) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (J{1 02 SINGLE WALLED f ] 03 LINED <br /> D. 6) 01 CARBON STEEL ( ) 02 STAINLESS STEEL l ) 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( 7 05 CONCRETE <br /> l ) 06 ALUMINUM (X) 07 STEEL CLAD f ) 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> f ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> No/ `11/ <br />