Laserfiche WebLink
'*F" STATE ID MWER 0000 Q,9668Q03 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> �l NEW PERMIT ( 1 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> r-) 02 CONDITIONAL PERMIT f ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COPPORATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> CAL TRANS ( ) 01 FED 3( j, 02 STATE ( l 03 LOCAL <br /> STPEET ADDRESS CITY S1iTtE ZIP <br /> 1976 E. CHARTER WAY STOCKTON CA 95205 <br /> II FACILITY <br /> FACILITY NAM' !^`-� DEALER/FOREMAN/SUPERVISOR <br /> SxK4"%lFFF5 � ..... BOB SUMMERS <br /> STPEET ADDPESS NEAREST CROSS STREET <br /> 1604 'S' B ST. CHRTR. WAY/B ST. <br /> CITY COUNTY 04* ZIP <br /> STOCKTON SAN JOAQUIN .+� X95206 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 1604 'S' B ST. 4TOCKTON CA 95206 <br /> PHONE W/APEA CODE TYPEOF BUSINESS <br /> 209-369-6901 ( ) O1 GASOLINE STATION (X) 02 OTHER MAINTENANCE STATION <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 3 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DA,S: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> BOB SUMMERS 209-95�•iY87�gf T-7. SAME -q }=�" <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 306-A <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED 5 HW UNKNOWN <br /> 0. CONTAINER CAPACITY: LziaGALLONS HH 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 /> ( ) <br /> 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ) 04 DIESEL ( ) 05 WASTE OIL (-X7'06 OTHER UNKNOWN <br /> V CONTAINER CONSTRUCTION o <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( ) INCHES f ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) W 02 NON-VAULTED H(7 03 UNKNOWN <br /> C. ( l 01 DOUBLE WALLED ( ) 02 SINGLE WALLED ( l 03 LINED <br /> D., 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> s+( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE f ) 09 COMPOSITE ( 7 10 NON-METALLIC <br /> 4)d 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />