Laserfiche WebLink
\ STATE I0 BER 00000064217001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STOR E TANK <br /> 1 I <br /> 01 NEW PERMIT ( 1 OS RENEWED PERMIT ( ) 07 TANK CLOSED (V49 DELETE FROM FILE (NO FEE) <br /> 1 102 CONDITIONAL PERMIT ( l 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> OWNER <br /> Ie ME(COPPOPAT ON.INDIVID L OR PUBLIC AO NCYI r �t IC. U PUBLIC AGENCY ONLY <br /> yfNd8Ac1 0.r 1^ ( l 01 FED ( l 02 STATE l ) 03 LOCAL <br />;TREET ADDRESS II CITYSTATE 2IP <br /> MANTECA CA 95336 <br /> I FACILITY <br />'ACILITY NAME DEALER/FOREMAN/SUPERVISQR <br /> OSE TEXACO F(�f Q <br /> ITPEET ADDRESS NEAREST CROSS STREET ki <br />)41 E. YOSEMITE AVE. POWERS AVE. <br /> ::TY COUNTY ZIP <br /> IANTECA SAN JOAQUIN 95336 <br /> MAILING ADDRESS CITY STATE ZIP <br /> )41 E. YOSEMITE AVE. MANTECA CA 95336 <br /> HONF W/AREA COD �^Y-�� qG� TYPEOF BUSINESS <br /> �07•CL�Yt2DY r '��`,J� t l ( <br /> X) <br /> 01 GASOLINE STATION f 1 92 OTHER <br /> IVMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 5 <br /> II 24 HOUR EMERGENCY CONTACT PERSON <br /> MAYS: NAME(LAST NAME FIRST) AND PHONE W/ARG CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/ARCA CODE <br /> _-t4T=8£S-ZBD6, 1 - <br /> �d <br /> ETE T <br /> COMP HE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> V DESCRIPTION <br /> L. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 1 <br /> I. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> 1. CONTAINER CAPACITY: 1000 GALLONS f 1 UNKNOWN E. DOES THE CONTAINER STORE: 1 ) 01 WASTE (X) 02 PRODUCT <br /> DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ESI: <br /> (X) 01 UNLEADED ( ) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( 1 05 WASTE OIL ( ) 06 OTHER <br /> CONTAINER CONSTRUCTION <br /> �. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( ) INCHES f 1 CM (X) UNKNOWN <br /> 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (XI 02 NON-VAULTED f ) 03 UNKNOWN <br /> % l ) 01 DOUBLE WALLED l 102 SINGLE WALLED l ) 03 LINED <br /> I. ( 1 01 CARBON STEEL f 1 02 STAINLESS STEEL ( ] 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM l 1 07 STEEL CLAD l 1 08 BRONZE l 1 09 COMPOSITE l ) 10 NON-METALLIC <br /> 1X1 12 UNKNOWN ( ) 13 OTHER: <br /> IC04-070185 (10/18/85) PAGE 1 <br /> C <br />