Laserfiche WebLink
STATE ID NUMBER 00000065878002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> 01 NEW PERMIT ( l 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (ND FEE) <br /> ( ] 02 CONDITIONAL PERMIT t ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> SAN JOAQUIN COl1NTY ( ) 01 FED ( ) 02 STATE (kl' 03 LOCAL <br /> CITY STATE <br /> STREET ADDRESS CA92121 <br /> 952 <br /> Z2.2- E. W4,10er STOCKTON <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> OAK GROVE PARK J ee- LT )%ar r em <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 4520 W. EIGHT MILE ROAD 1-5 <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95209 <br /> MAILING ADDRESS n ' CITY STATE ZIP <br /> PBSF-OCFiBE-sax-161.o yS7O l.✓. E�gMIC �Gl• STOCKTON CA 95204 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-944.41172 yyS ( ) 01 GASOLINE STATION (X) 02 OTHER COUNTY PARK <br /> NUMBER OF CONTAINERSRVRAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 2 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAMEILAST NAME FIRST) AND PHONE W/ARCA CODE <br /> 209+..x,=a. NIGHT NATCHMAN 209-944-2281 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( 1 04 OTHER: CONTAINER NUMBER_W 2 _ <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED /9pe L*r UNKNOWN <br /> D. CONTAINER CAPACITY: �GALLONS ( ) 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 ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> (X) 01 UNLEADED l ) 02 REGULAR ( ) 03 PREMIUM ( 1 04 DIESEL ( D 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( 1 GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( l 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (W 02 SINGLE WALLED ( 1 03 LINED <br /> 0. tAd 01 CARBON STEEL ( 1 02 STAINLESS STEEL ( l 03 FIBERGLASS l 1 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> r 1 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE t ) 09 COMPOSITE f ! 10 NON-METALLIC <br /> LDH 12 UNKNOWN ( 1 13 OTHER: <br /> HSC04-070185 (08/29/86) PAGE 1 <br /> *// <br /> 1 <br />