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STATE ID NUMBER 00000032880003 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) <br /> 01 NEW PERMIT [ 1 OS RENEWED PERMIT ( ) 07 TANK CLOSED <br /> ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> JOHN TAYLOR OF STOCKTON ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITY STATE IIP <br /> 1819 SO. ARGONAUT STOCKTON CA 95206 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> JOHN TAYLOR OF STOCKTON <br /> STPEET ADDRESS NEAREST CROSS STREET <br /> 1819 SO. ARGONAUT CHARTER WAY <br /> CITY COUNTY IIP <br /> STOCKTON SAN JOAQUIN 95206 <br /> (^.AILING ADDRESS CITY STATE IIP <br /> PO BOX 6098 STOCKTON CA 95206 <br /> PHONE W/APIA CODE TYPE OF BUSINESS <br /> 209-944-9951 ( ) 01 GASOLINE STATION (X) 02 OTHER AG DEALER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 3 <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 /> STEVENSON, ROY 209-944-9951 STEVENSON, ROY 209-473-8460 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 523003 <br /> S. MANUFACTURER (IF APPROPRIATE): PERKINS YEAR MFG: 1969 C. YEAR INSTALLED 1969 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 10000 GALLONS ( 1 UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 01 YES [ l 02 NO IF YES CHECK APPROPRIATE BOX(ES)- <br /> 01 <br /> OXESYO1 UNLEADED ( l 02 REGULAR ( ) 03 PREMIUM (X) 04 DIESEL l ) 05 WASTE OIL ( l 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 1/4 ( 1 GAUGE (X) INCHES ( ) CM ( ) UNKNOWN <br /> S. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( 1 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( l 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL l ) 03 FIBERGLASS [ 7 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM t 1 07 STEEL CLAD ( ] 08 BRONZE ( 1 09 COMPOSITE ( ) 10 NON-METALLIC <br /> l ] 12 UNKNOWN ( ) 13 OTHER: <br /> NSC04-070185 (10/18/85) PAGE 1 <br /> an► -,,oft <br />