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STATE ID NUMBER 00000019658004 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED f ) 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 /> WOOLSEY OIL INC. ( ) 01 FED ( 1 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITYSTATE ZIP <br /> 166 FRANK WEST CR, STOCKTON CA 95231 <br /> I1 FACILITY <br /> FACILITY NAME DEALER/FOREMAN PlAVISOR <br /> WOOLSEY OIL INC <br /> STPE!T ADDRESS NEAREST CROSS STREET <br /> 166 FRANK WEST CR. FRENCH CAMP <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95231 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 166 FRANK WEST CR. STOCKTON CA 95231 <br /> PHONE W/AREA CODE TYPEOF BUSINESS <br /> 209-948-9412 ( ) 01 GASOLINE STATION (X) 02 OTHER PETROLEUM DIST. <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 11 <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 /> WOOLSEY, BRUCE 209-334-0652 WOOLSEY BRUCE 209-334-0652 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER M4 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: 1981 C. YEAR INSTALLED 1981 f ) UNKNOWN <br /> D. CONTAINER CAPACITY: 8000 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 ? l ) 01 YES (X) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM f 1 04 DIESEL f l 05 WASTE OIL ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 10 (X) GAUGE f 7 INCHES ( ) CH f ) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED f ) 03 LINED <br /> 0. (X) 01 CARBON STEEL ( 1 02 STAINLESS STEEL ( 1 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD f 1 08 BRONZE ( 1 09 COMPOSITE [ ) 10 NON-METALLIC <br /> ( 7 12 UNKNOWN ( ) 13 OTHER: <br />• HSC04-070185 (10/18/85) PAGE 1 <br />