Laserfiche WebLink
0 <br /> STATE ID NUMBER 00000059193001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> Lt) 01 NEW PERMIT ( l 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEEL <br /> ( ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COPPOPATION,INDIVIDU.AL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> T7ry��f' c i l 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS IT-k J CITY STATE ZIA <br /> 60 A& STOCKTON CA 95207 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> WATER FRONT YACHT HARBOR ROY A. GRUWELL <br /> STREET ADOPESS NEAREST CROSS STREET <br /> 333 TULEBERG LEVEE CENTER <br /> JCITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95203 <br /> MAILIN3 ADOPESS CITY TCA <br /> TATE ZIP <br /> 333 TULEBERG LEVEE STOCKTON 95203 <br /> PHONE W/AREA COC-: =TYPEBUSINESS <br /> 209-943-1848 GASOLINE STATION (X) 02 OTHER MARINA <br /> NUMBER OF CONT,:_-�EzS PUPAL AREAS ONLY . TOWNSHIP RANGE SECTION <br /> 3 <br /> I-II 24 HOUR EMERGENCY CONTACT PERSON <br /> LGRUIWELL* <br /> : NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> JERUWELLNROY <br /> ME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> ROY 209-943-1848 209=369-5753 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER I <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED 1981 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 5000 GALLONS i 1 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 /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM (X) 04 DIESEL ( ) 05 WASTE OIL i 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 1/4 ) GAUGE (X) INCHES ( l CM ( ) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) 0() 02 NON-VAULTED 4*—03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (.X+ 02 SINGLE WALLED ( ) 03 LINED CtkiK",QoJ4 <br /> D. (X} 01 CARBON STEEL i ) 02 STAINLESS STEEL OC) 03 FIBERGLASS I ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08' ONZE ( ) 09 COMPOSITE ( l 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> KSC04-070185 (.10/18/85) PAGE 1 <br />