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0 0 <br /> STATE ID NUMBEP 00000038574001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> j.t"1 NEW PERMIT f l 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT { } 06 AMENDED PERMIT ( } 08 MINOR CHANGE (NO SURCHARGE) J <br /> I OWNER <br /> NAME(CORPOPATION,INDIVICUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> ROY L. & CONNIE BECK <br /> ( ) 01 FED ( ) 02 STATE C ) 03 LOCAL <br /> STREET .ADCPESS <br /> 3900 LONGRIDGE AVE. =SHEYMAN <br /> STATE ZIP <br /> AKS CA 91423 <br /> II FACILITY <br /> FACILITY N4":E <br /> DEALER/FOREMAN/SUPERVISOR <br /> BEACON STATION # 492 LAUREN RAUCHMAN <br /> STPEET ADOPESS NEAREST CROSS STREET <br /> 470 NORTH MAIN STREET ALAMEDA STREET <br /> CITY <br /> MANTECA COUNTY ZIP <br /> SAN JOAQUIN 95336 <br /> 'MAILING ADDPESS CITY <br /> 525 W. THIRD STREETHANFDRD CARTE 9ZIP <br /> 3230 <br /> PHONE W/AREA CODE T'TPE OF BUSINESS <br /> 209-582-0241 (X) 01 GASOLINE STATION ( l 02 OTHER <br /> NUMBER OF CONTAINE=S PUPAL AREAS ONLY : TOWNSHIP RANGE <br /> 3 SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(L.AST NAME FIRST) AND PHCNE W/AREA CODE NIGHTS: NAME( LAST NAME FIRST! AND PHONE W/AREA CGDE <br /> MCCUTCHEN, JIM 209-582-0241 _ SHIFT SUPER`dISOR 209-582-0246 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER. <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( 1 04 OTHER: CONTAINER NUMBER 41:,�-,-1 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED 1964 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 10000 GALLONS ( 1 UNKNOWN E. DOES THE CONTAINER STORE: ( 1 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 ( ) 02 REGULAR ( ) 03 PREMIUM (X) 04 DIESEL ( } 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: .025 ( ) GAUGE (X) INCHES f ) CM ( ) 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 ( ) 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CCtJCRETE <br /> ( 1 06 ALUMINUM ( ) 07 STEEL CLAD f 1 08 BRONZE ( 1 09 COMPOSITE ( ) 10 NON-METALLIC <br /> f ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) <br /> PAGE 1 <br />