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STATE ID NUMBER 00000035653001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) O1 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( l 09 DEE FROM FI=(NOFEE) <br /> LET <br /> ( ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NA^!E(COPPOPAT:ON,IND:VIDUAL OR PUBLIC AGENCY) <br /> ENI MENCONI PUBLIC AGENCY ONLY <br /> ( l <br /> 01 FED ( ) 02 STATE ( l 03 LOCAL <br /> STREET ADDRESS <br /> 10799 S. WING LEVEE RD. CITY STATE zIP <br /> STOCKTON CA 95206 <br /> II FACILITY Dan �3G ('Gfl 21 bZ- <br /> FACILITY NAME ERVISOR !-� c'"_ <br /> ENI MENCONI DEALER/FOREMAN/SUP <br /> �} ' �' � �,e.....+.^ <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 10799 S. WING LEVEE RD. <br /> CITY \_____ <br /> STCCKTON � „ COUNTY ZIP <br /> ( <br /> 6z--) SAN JOAQUIN 95206 <br /> MA_LING ADDRESS /, ' CITY e� <br /> �'�� S W1 p ! .►TOCKTON CARTE ZIP <br /> PHONE W!.APEA CODE TYPE OF BUSINESS <br /> 209-465-8644 ( ) 01 GASOLINE STATION ( ) 02 OTHER <br /> 2 NUMBER OF CONTAINERS RURAL .AREAS ONLY TOWNSHIP RANGE SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: N.AME(L.AST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/APER CODE <br /> MENCONI, ENI 209-465-8644 C <br /> ENi �ENGOrr i - - <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 1 <br /> B. MANUFACTURER (IF APPROPRIATE): UNKNOWN YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> -----[ <br /> D. CONTAINER CAPACITY: 300 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE ( ) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? f ) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( ) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( ) 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 16 (X) GAUGE ( ) INCHES ( ) CM ( ) UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( l 03 UNKNOWN <br /> C. ( ) 01 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 f ) 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) <br /> PAGE 1 <br />