Laserfiche WebLink
• • STATE ID NUMBER 00000015618001 <br /> APPLICATION FOR PERMIT TO `O/PERATE UNDERGROUND STORAGE TANK <br /> YI1 01 NEW PERMIT f 1 05 RENEWED PERMIT Vl) 07 TAN. Wit [ 1 09 DELETE FROM FILE (NO FEET <br /> ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT f 1 08 R CHAR (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPORATION,INDIVIDUAL OP. PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> TRACY RURAL FIRE DEPT f I O1 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 77OT: W. LINNE RD TRACY CA 95376 <br /> II FACILITY <br /> FACILITY NAME DE'A/LER/F,OrRCEM..AN/SUPEERRVISOR p7 <br /> TRACY RURAL FIRE DEPT <br /> JA <br /> STREET <br /> STREET ADDRESS NEAREESnr CROSS.P:�LT <br /> 7700n W LINNE RD (x+25✓rW.� <br /> CITY COUNTY ZIP <br /> TRACY SAN JOAQUIN 95376 <br /> MAILING ADDRESS <br /> CITY STATE ZIP <br /> 7700 ; W LINNE RD TRACY CA 95376 <br /> PHONE W/APEA CODE TYPE OF BUSINESS <br /> 209-835-1123 ( 7 01 GASOLINE STATION (X) 02 OTHER FIRE DEPT <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY : TOWNSHIP RANGE SECTION <br /> 1 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAMV IAS7 NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> — 209-836-0504 SAME - <br /> R, js PARB6G�J NJ d{R)J f <br /> '° -,,?-rETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ] 04 OTHER: CONTAINER NUMBER <br /> B. MANUFACTURER (IF APPROPRIATE): PERKINS YEAR MFG: 1978 C. YEAR INSTALLED 1978 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 1000 GALLONS t ) UNKNOWN E. DOES THE CONTAINER STORE: f 1 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 01 YES ( 1 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( l 01 UNLEADED ( 7 02 REGULAR ( l 03 PREMIUM (X) 04 DIESEL f 1 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 10" (X) GAUGE ( ) INCHES ( ) CM f ) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( 1 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( 1 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE f ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD f 1 08 BRONZE f 1 09 COMPOSITE f ) 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE i <br />