Laserfiche WebLink
IgBZ <br /> STATE ID NUMBER 00000002363004 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> "``� <br /> f ) 01 NEW PERMIT ( 105 RENEWED PERMIT ( ) 07 TANK CLOSED G ' 09 DELETE FROM FILE (NO FEE) <br /> { ) 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE)' <br /> I OWNER <br /> NAME(CCRPOPATION,INDIVIOUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> JIM THORPE OIL INC ( ) 01 FED [ ) 02 STATE ( 1 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 351 N BECKMAN RD. LODI CA 95240 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> LINDEN SHORT STOP FUAEL MOHAMMED <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 18974 MAIN ST <br /> CITY COUNTY ZIP <br /> LINDEN SAN JOAQUIN 95236 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 18974 MAIN ST LINDEN CA 95236 <br /> PHONE W/APEA CODE TYPE OF BUSINESS <br /> 209-887-3089 lX) 01 GASOLINE STATION ( ) 02 OTHER <br /> NUMBER. OF CONTAINEoS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 4 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME( LAST NAME FIRST) AND PHONE W/AREA COOK NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> JIM THORPE OIL INC 209-368-6175 RICHARD THORPE 209-369-7440 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (XI 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 4 <br /> B. MANUFACTURER (IF APPROPRIATE): PERKINS WELDING YEAR MFG: 1960 C. YEAR INSTALLED 1960 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 500 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: (X) 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 /> ( ) 01 UNLEADED ( 1 02 REGULAR ( 1 03 PREMIUM ( ) 04 DIESEL f 1 05 WASTE OIL (X) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 10 (X) GAUGE f 1 INCHES ( ) CM f I UNKNOWN <br /> B. ( ) 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED (X) 02 SINGLE WALLED f 103 LINED <br /> D. (X) 01 CARBON STEEL ( 1 02 STAINLESS STEEL ( 1 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( 1 08 BRONZE ( ] 09 COMPOSITE f ) 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />