Laserfiche WebLink
. . <br /> STATE ID NUMBER 00000011E94E1TY' <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> [�CY� 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED <br /> ( ) 09 DELETE FROM FILE (NO FEE) <br /> Cf'S`02 CONDITIONAL PERMIT ( 7 06 AMENDED PERMIT [ 1 OB MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> PUBLIC AGENCY ONLY <br /> NAME(CORFORATION,INDIVIDUAL OR PUBLIC AGENCY) ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> CALIFCRNIA WATER SERVICE CO. <br /> CITY STATE ZIP <br /> STREET aooREss SAN JOSE CA 95112 <br /> 1720 N. FIRST STREET <br /> II FACILITY <br /> DEALEP/FOREMAN/SUPERVISOR <br /> FACILITY NAME M. E. CAMY, MANAGER <br /> STA. STOCKTON <br /> STPE= ADDRESS ( )L W NEAREST CROSS STREET <br /> COUNTY I P <br /> CITY SAN JOAQUIN 95202 <br /> STOCKTON STATE ZIP <br /> CITY CA 95202 <br /> MAILING ADDRESS STOCKTON <br /> 1111 NO. EL DORADO ST. <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-466-8971 ( ) 01 GASOLINE STATION (X) 02 OTHER AUX. ENGINE <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP <br /> RANGE SECTION <br /> x <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAMECLAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> -&-209-46tr' M. E. CAMY 209-478-4708 -g <br /> M.E. CAMY g <br /> COMPLETE 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): YEAR MFG: C. YEAR INSTALLED 1971 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: OF-GALLONS ( l UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES 0THE <br /> CONTAINER STORE <br /> RMOTOR <br /> VEHICLE <br /> FUEL <br /> ORMWASTE OIL <br /> OIESEL O( )YES <br /> 05 ( ) 020 o (I) YES <br /> OCHECK APPROPRIATE BOX(ES): <br /> 04 <br /> V CONTAINER CONSTRUCTION o <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED ( ) 03 LINED <br /> D. (X)(0; CARBON <br /> ALUMINUM (( I) STAINLESS <br /> STEEL <br /> 08(BRONZEF IBERG09SCOMPOSITE POLYVINYL <br /> NONHMETAL05 CONCRETE <br /> 1 03 LIC( ) <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> PAGE 1 <br /> HSC04-070185 (10/18/85) <br />