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-Y1 l c m.'t_" L� STATE IO NUMBER 00000060392004 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( l O1 NEW PERMIT ( ) 05 RENEWED PERMIT l ) 07 TANK CLOSED 1 09 DELETE FROM FILE (NO FEEL <br /> [ ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( 1 OB MINOR CHANGE (NO SURCNARG 1 <br /> I OWNER <br /> NAME(CORP OR ATSON.INO IVIOVAL OR PUDLIC AGENCY) PUBLIC AGENCY ONLY <br /> j 01 FED l ) 02 STATE 1103 LOCAL <br /> CLAUDE C. WOOD COMPANY <br /> CITY STATE ZIP <br /> STREET ADDRESS LODI CA 95240 <br /> 686 E. LOCKEFORD <br /> II FACILITY <br /> FACILITY NAMEM -L l_O DEALER/FOREMAN/SUPERVISOR <br /> uaJ� (,`f - air. J1�, BOB WHITEMORE <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 686 E. LOCKEFORD HWY. 99 <br /> COUNTY IF <br /> CITY SAN JOAQUIN 95240 <br /> LODI <br /> MAILING ADDRESS CITY STATE ZIP <br /> POST OFFICE BOX 599 LODI CA 95241 <br /> PHONE W/APEA CODE TYPE OF BUSINESS <br /> 209-334-0790 ( ) 01 GASOLINE STATION (X) 02 OTHER CONSTRUCTION <br /> NUMBEROF CONTAINERS RURAL AREAS ONLY : TOWNSHIP RANGE SlCTION <br /> 4 <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/ARCA CODE <br /> 008 WHITEMORE 209-334-0790 BOB WHITEMORE 209-727-5721 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 5 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 500 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE ( ) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? ( ) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( 1 01 UNLEADED f ) 02 REGULAR ( 1 03 PREMIUM ( ) 04 DIESEL ( 1 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 1/4 ( ) GAUGE (X) INCHES ( ) CM ( I 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 ( l 03 LINED <br /> D. (X) 01 CARBON STEEL ( 1 02 STAINLESS STEEL l ) 03 FIBERGLASS ( l 04 POLYVINYL CHLORIDE f ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( 107 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE f ) 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />