Laserfiche WebLink
STATE ID NUMBER 00000000723003 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> 01,NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> N.AM€(COPPOPATION,INDI�'IDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> K +� -TA a r ( ) OI FED ( ) 02 STATE ( 03 LOCAL <br /> STREET ADDRESS l�"� CITY STATE ZIP <br /> �`fC)O l! �` W G 1 c(lT l�✓�T!/� CA[ 9 <br /> II FACILITY <br /> FACILITY NAME DEALEPiFOREM,4N/SUPERVISOR <br /> FRANKS EXXON #4 FRANK GUINTA <br /> STREET ACOPESS NEAREST CROSS STREET <br /> 14800 W. FRONTAGE RD. <br /> CITY FSAN <br /> Y ZRP <br /> MANTECA OAQUIN <br /> `^AILING ACDRESS CITY STATE ZAP <br /> P.O. BOX 67 BANTA CA 95336 <br /> PHONE W/AP.EA CODE TYPEOF BUSINESS <br /> 209-239-2717 (X) 01 GASOLINE STATION i ) 02 OTHER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 3 <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 /> MOORE, JERRY 209-835-2750 MOORE, JERRY, 209-946-0749 <br /> COMPLETE THE 'FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER ]CONTAINER NUMBER 12 <br /> B. MANUFACTURER (IF APPROPRIATE)= PERKINS YEAR MFG: C. YEAR INSTALLED rMMIMIIT <br /> D. CONTAINER CAPACITY: 10000 GALLONS f ) 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 /> ( 1 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM (X) 04 DIESEL f ) 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 1/4 ( l GAUGE (X) INCHES ( ) CM ( 1 UNKNOWN <br /> 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( 1 Oi DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL l ) 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ) 06 ALUMINUM ( ) 07 STEEL CLAD ( 1 08 BRONZE ( 1 09 COMPOSITE ( ) 10 NON-METALLIC <br /> l ) 12 UNKNOWN ( ) 13 OTHER <br /> HSC04-070185 (10/18/85) PAGE 1 <br />