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STATE IO NUMBER 00000049766004 <br /> APPLICATION FOR PERMIT TO OP T l�ROUND ST RAGE TANK <br /> ( ) 01 NEW PERMIT I 1 05 RENEWED PERMIT 07 ) 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( OR (NO SURCHARGE) <br /> I OWNER <br /> NAM![CCPPOP.ATION,ZNDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> FRANCES F. OKAMOTO ( ) 01 FED ( 1 02 STATE C ) 03 LOCAL <br /> ST=EE'T ADDPESS CITY STATE T9520 <br /> 431 WEST JEFFERSON STOCKTON CA 6 <br /> II FACILITY <br /> FACILITY '- E DEALER/FOREMAN/SUPERVISOR <br /> OKAMOTO SERVICE KATSUMI UYEDA <br /> STPEer ADDpGSS NEAREST CROSS STREET <br /> 145 SOUTH SUTTER WASHINGTON ST. <br /> CITY COUNTY YIP <br /> STOCKTON SAN JOAQUIN 95202 <br /> MAILING ADOR-ESS CITY STATE ZIP <br /> 145 SOUTH SUTTER STOCKTON CA 95202 <br /> PHONE W/.AREA CODE TYPE OF BUSINESS <br /> 209-943-1158 (X) 01 GASOLINE STATION ( ) 02 OTHER <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY : TOWNSHIP RANGE SECTION <br /> 4 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAM! FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> OKAMOTO, FRANCES 209-464-8287 SAME - - <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER IV <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED 1968 ( 1 UNKNOWN <br /> D. CONTAINER CAPACITY: 1000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: (X) 01 WASTE ( ) 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 /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( 1 04 DIESEL (X) 05 WASTE OIL f ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: I ] GAUGE f ) INCHES ( l CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) f ) 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. C ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED ( 1 03 LINED <br /> D. (X) 01 CARBON STEEL f ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM C ) 07 STEEL CLAD ( ) 08 BRONZE ( 1 09 COMPOSITE ( ) 10 NON-METALLIC <br /> E ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />