Laserfiche WebLink
• STATE I0 NUMBER 00000016663017 <br /> _` APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> (�cl 01 NEW PERMIT ( 7 05 RENEWED PERMIT 0(1 07 TANK IMEE 'Z ((� g ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( 1 02 CONDITIONAL PERMIT t ) 06 AMENDED PERMIT ( 1 08 MINOR CHANGE NO �UXHARGE) <br /> I OWNER <br /> NAME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> MCCORMICK AND BAXTER CREOSOTt-NG' ( ) 01 FED ( ) 02 STATE f l 03 LOCAL <br /> STPEET ADDRESS CITY STATE ZIP <br /> 6900 N EDGEWATER PORTLAND OR 97203 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN4SUUPPEPVISOR _ <br /> MCCORMICK AND BAXTER CREOSOTING- BILL FEGLEY (/L/(1 <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 1214 W. WASHINGTON STREET PERSHING <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN i <br /> 1 95203 <br /> MAILING ADDRESS CITY STATE ZIP <br /> P.O. BOX 1728 STOCKTON CA 95201 <br /> PHONE W/APER CODE TYPE OF BUSINESS <br /> 209-465-5767 ( ) 01 GASOLINE STATION (X) 02 OTHER WOOD PRESERVATION <br /> NUMBER OF CCNTAINEPS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 19 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) ANO PHONE W/AREA CODE <br /> SHIBA, LARRY 209-465-5767 SHIBA, LARRY 209-465-5767 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 017 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED tX) UNKNOWN <br /> D. CONTAINER CAPACITY: /OV6 GALLONS (X) 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 (X) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL f 1 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: f ) GAUGE ( ) INCHES ( 1 CM (X) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( ) 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( 1 02 SINGLE WALLED f ) 03 LINED <br /> D. ( ) 01 CARBON STEEL f ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( l 07 STEEL CLAD ( 1 08 BRONZE ( 1 09 COMPOSITE t 1 10 NON-METALLIC <br /> (X) 12 UNKNOWN ( . ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE I <br />