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• � � � • STATE ID NUMBER�,000000139^7001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ] <br /> 01 NEW PERMIT f ) 05 RENEWED PERMIT 1 07 TANK CLOcFn l 1 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( 7 06 AMENDED PERMIT ( ANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> KAYO OIL COMPANY ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITYSTATE ZIP <br /> 1221 E. MAIN STREET CHATTANOOGA TN 37408 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> FAST GAS <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 153. E. 11TH STREET <br /> CITY COUNTY ZIP <br /> TRACY SAN JOAQUIN - 95376 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 153 E. 11TH STREET TRACYTN 95376 <br /> PHONE W/AREA CODE TYPE OF BVSINESS <br /> 209-835-9990 (X) 01 GASOLINE STATION ( ) 02 OTHER <br /> NVMSEP OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 3 <br /> II1 24 HOUR EMERGENCY CONTACT PERSON <br /> GAYS: <br /> NA <br /> NAME FIPST) AND PHONE W/APEA CCCE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> i <br /> HARTNEY, JOE ___ ==� HARTNEY. JOE 509-926-1927 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( 1 04 OTHER: CONTAINER NUMBER 1 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED 1963 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 5000 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 /> ( ) 01 UNLEADED ( ) 02 REGULAR (X) 03 PREMIUM ( ) 04 DIESEL ( ) 05 WASTE OI-L l ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE f ) INCHES ( ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) EX) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( l 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( 1 08 BRONZE ( i 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( l 12 UNKNOWN ( ) 13 OTHER: <br /> KSC04-070185 (10/18/85) PAGE 1 <br /> d <br />