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_ _ �d _7" INV. NO. Joe. ACCOUNT _ 9U9. DI�E• R8T' Rc+"" t.�n NAMC bA T� OR REF, NO _ AYA OLi` MI !IAL CONTRACT AgCT. TI AMOUNT _..e DAT[ INVOICE N0. AMOUNT OA1E INVOICE NO. AMOUNT DATE INvolc 1-1111T N0. b.L.MCLAUGHffl GU.rre BTOCKTON,CA.05NI i Glc( Cnec A`S7/ who Most ralf; I.W.rl Ina nun nun"rl .nv o..rv.n, ......... .. .... . . 1 ground u0nlalnur must file this tuun 110 liner than July 1. 1994(Alun OF,lubut Fee; For odt'.b 10111, logwlulud It 510 too thus, Lou paid. uxeupt Ih'at to a' .a 1. 1964 and no alar than January 1, 1965 fur lanky Used on loons( gusdhnu Statluns pay $5 per lank De11EYllon of Underground Containers: The law applies 10 'cnnClrle penalties; For lullure In file.the penally Is 5500-55.000 P,;(do 11 you III try sumps, nonvaulted buried lanky or other underground containers IWalol Information. you call bo flood up to$20.000 lot each day the Information Is Code section 13173) All containers. Including earthen Walled pts. ponds. Incorrect and has not been corrected. lagoons and sumps, that are below the normal ground surface level must Confidentiality: If you have information protected by trade secret laws. register A lank stung on the ground is not included Containers partially please attach it list of the information On this loom that is conlldential and the beneath the surface are Included Loud or unlined pais ponds and lagoons lustihcafion lot confidentiality. Includingspecific citations of relevant state• are covered If earth has been removed from the storage area to const roti toty and case law the facility. Normal grading is not considered construction below green tl Multiple Containers: Fill I and If on one form and leave it blank on all the levelremaining lonos All.,, all forms together securely. If you own more than Definition of Hazardous Substance: Any substance listed In Section 6362 50 ranks you can IIIc Information on computer tape. Call 916/324-1262 for or the Labor Code or In Section 25316 of the Health and Safety Code. This inlormation Includes'. gasoline. diesel fuel. all industrial solvents, pesticides. herbicides This b not•Permit Applleallon. All Underground Tanks will be sWlecl to and fumigants at a It the us wase must be tamed by a registered hauler. els- local fe ulahon. Sonic jurisdictions have already begun programs Check posed o1 ata hazardous waste Slle,is explosive.generates u ''scut r due to with our local count government for further Information. Heal a decomposition or would harm humans w wildlife you must register Y Y NOTE: ALL UNDERGROUND CONTAINERS MUST REGISTER EVEN IF STATE AND/OR LOCAL PERMITS ARE IN FORCE. 1 Owner Name ICaporaoon.Indlwdual or Pobuc Agencyl D. L. McLaughlin Co. Inc. 9114 Adonis C�IY stele 21P 2829 N. Highway 99 Stockton CA 95205 II Facility iacNY Nome diaav Fnenra^ Suycrvnor Nearest Caws seen 9reM ADdess ZIP CRY Cnunry MaRinD AWvrex CRY Sl,ni ZIP PNWe wlarea CWL TYPn al eusrmss pail Motor Vehicle Fuel Station ❑02 Other: Numbs R d Tarlss aI IM1Ie Faclxq flYEM A/Os Township Nany.' $eClNln Only: III 24 Hour Emergency Contact Person Nr Is Nanrc llasl nemu Inslr nnJ PWrkr w arca Cure Days.Name Ilasl name LRII and PM1one wlarea tour Oh ` COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER IV Description _ CMWMr NYTWr III IM1crc 15 no nt,10d' assert Wil A. (•kol Tank 002 Sump Ow Lagoon, Pit or Pond ON Other: ----- - --- l xy : unknOwn Year of Mf C. Year Installed: 1(3 Unknown B. Manufacturer(if appropriate). g�� D. Container Capacity: gallons V Unknown E. Container Repairs: ❑oI None HCl o2 Unknown ❑w Yes Year: ,.h.. . F. Is Container currently used? 5j of Yes ❑w No If No, year of last use: ❑w Unknown G. Does the Container Store(Check One): ❑or Waste :I o2 Product H. Does.the Container Store Motor Vehicle Fuel mCW110009? 7001 Yes ❑w No If Yes, Check appropriate box(es): O m Unleaded MaRegular O o3 Premium O N Diesel O m Waste Oil Elm Other(List): — �l. ±' V Container Construction - – — 4;', A. Thickness of Primary Containment: ❑ Gauge ❑ Inches ❑ cm ?§ Unknown B. ODr Vaulted (Located in an underground Vault.) 002 Non-vaulted No Unknown C. ❑or Double Walled O 02 Single Walled ❑w Lined ❑a Wrapped Bob Unknown ❑do None D. O oI Carbon Steel O w Stainless Steel ❑w Fiberglass ❑o. Polyvinyl Chloride ❑m Concrete ❑W Aluminum ❑w Steel Clad ❑tie Bronze O dl Composite O t0 Non-metallic ❑ u E arthen Walls OC12 Unknown O 13 Other: E. O til Rubber Lined ❑02 Alkyd Lining Ow Epoxy Lining ON Phenolic Lining O on Glass Lining ❑m Clay Lining O o, Unlined Z to, Unknown O os Other: IF. 0 to Polyethlene Wrap 0-02 Vinyl Wrapping 0 113 Cathodic Protection f oa Unknown 0 os None 0 va Other: