Laserfiche WebLink
STATE ID NUMBER 00000009408001 <br /> APPLICATION FOR PERMIT T POPERATE UNDERGROUND STORAGE TANK <br /> ( J 01 NEW PERMIT [ ) 05 RENEWED PERMIT ( 1 07 TANK CLOSED FEE) <br /> f ) 02 CONDITIONAL PERMIT t ) 06 AMENDED PERMIT t 1 08 MINOR CHANGE (NO SURCHARG 3 <br /> i OWNER <br /> NAME(CCPPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> OAS BUILDING ACCOUNT ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS :�:[PEB5LE <br /> ITY STATE ZIPP.O. BOX 486 BEACH CA 93956 <br /> Ii FACILITY <br /> F4CILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> HOLT MOTORS PETE SILVANI <br /> STPEET ADDPESS NEAREST GROSS STREET <br /> 4873 WEST LANE BIANCHI <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95210 <br /> MAILING ADDRESS CITY STATE ZIP <br /> P.O. BOX 8790 STOCKTON CA 95208 <br /> PHONE WlAREA CODE =TYPEBUSiN°SS209-473-3811 GASOLINE STATION (X) 02 OTHER AUTO DE <br /> ALEP.SHIP <br /> NUMBER OF CONTAI-NERS RURAL AREAS ONLY �TOWWNSTOWNSHIPRANGE SECTION <br /> 1 <br /> III 24 HOUR EMERGENCY CONTACT PERSON, <br /> DAYS: NAME(LAST NAME FIRST) AND RHONE WJAREA CODE NIGHTS: NA E(LAST NAME FIRST) AND RHONE W/AREA CODE <br /> SILVANI5 PETE 209-473-3811 SILVANI> PETE 209-952-4444 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK E ) 04 OTHER: �CCHTAINER NUMBER 1 <br /> B. MANUFACTURER (IF APPROPRIATE) YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: GALLONS (X) UNKNOWN E. DOES THE CONTAINER STORE: tX) 01 WASTE ( 1 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 /> t ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL (X) 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINSiENT: t 1 GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> B. f ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( 1 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. f ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED ( 1 03 LINED <br /> 01 CARBON STEEL ( 1 02 STAINLESS STEEL ( ) 03 FIBERGLASS f ) 04 POLYVINYL CHLORIDE t ) 05 CONCRETE <br /> t ) 06 ALUMINUM ( ] 07 STEEL CLAD ( 1 08 BRONZE [ ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> (X) 12 UNKNOWN t 1 13 OTHER. <br /> HSC04-070185 (10/18/85) PAGE 1 <br />