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1 <br /> • �� STATE ID NUMBER 00000037573002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) O1 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED <br /> DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHA 7 <br /> I OWNER <br /> PUBLIC AGENCY ONLY <br /> NAME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) ( ) 01 FED ( 102 STATE ( 1 03 LOCAL <br /> LAMMERSVILLE SCHOOL DIST. <br /> CITY STATE IIP <br /> STREET ADDRESS TRACY CA 95376 <br /> 16555 W. VON SOSTEN RD. <br /> II FACILITY <br /> DEALER/FOREMAN/SUPERVISOR <br /> FACILITY NAME <br /> LAMMERSVILLE SCHOOL DIST. <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 16555 W. VON SOSTEN RD. <br /> COUNTYIIP <br /> TRACYCITY SAN JOAQUIN 95376 <br /> CITY STATE IIP <br /> MAILING ADDRESS TRACY CA 95376 <br /> 16555 W. VON SOSTEN RD. <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-835-0138 ( ) 01 GASOLINE STATION (XI 02 OTHER <br /> NUMBER,O`F CONTAINERS <br /> RURAL AREAS ONLY . TOWNSHIP RANGE SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE p NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> 209_49.1 :P.+ 'gj �'O <br /> KENNETH OLDS SAME - - S� - 399_0 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> [B. MANUFACTURER <br /> ) 01 TANK ( ) 0g <br /> CONTAINER NUMBER e T <br /> (IF ARKINS YEAR MFG: 1954 C. YEAR INSTALLED 1954 ( ) UNKNOWN <br /> NTAINER CAPACITYONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) O1 WASTE (X1 02 PRODUCT <br /> ES OIHUNLEAD EDHERMOTOR ICL03FUEL OR PREMIUMWA(T) 04LDIESEL O( IE05 WASTEOIL (I) 06 OTHER <br /> F YES K APPROPRIATE BOX(ESI: <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 10 (X) GAUGE ( ) INCHES ( ) CM ( ) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( 1 O1 DOUBLE WALLED (X) 02 SINGLE WALLED ( ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( 108 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( 1 12 UNKNOWN ( ) 13 OTHER: <br /> PAGE 1 <br /> KSC04-070185 (10/18/85) <br />