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NOW 1%w-d STATE ID NUMBER 00000019658009 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> (&1 01 NEW PERMIT ( 1 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 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 ( ) 02 STATE ( 1 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 166 FRANK WEST CR. STOCKTON CA 95231 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPE VISOR <br /> WOOLSEY OIL INC <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 166 FRANK WEST CR. FRENCH CAMP <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95231 <br /> MAILING ADDRESS CITYSTATE ZIP <br /> 166 FRANK WEST CR. STOCKTON CA 95231 <br /> PHONE W/AREA CODE 'TYPEOF BUSINESS <br /> 209-948-9412 ( 1 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 W49 <br /> B. MANUFACTURER (IF APPROPRIATE): UNK YEAR MFG: 1983 C. YEAR INSTALLED 1983 ( 1 UNKNOWN <br /> D. CONTAINER CAPACITY: 4000 GALLONS f 1 UNKNOWN E. DOES THE CONTAINER STORE: t ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? [ ) 01 YES (X) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( 1 01 UNLEADED ( 1 02 REGULAR ( 1 03 PREMIUM f ) 04 DIESEL ( 1 05 WASTE OIL !j) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 10 (X) GAUGE ( 1 INCHES ( 1 CM ( 1 UNKNOWN <br /> B. ( 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) 1X1 02 NON-VAULTED ( 1 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> f ) 06 ALUMINUM l ) 07 STEEL CLAD f ) 08 BRONZE ( 1 09 COMPOSITE ( 1 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( 1 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />