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STATE ID NUMBER 00000011236002 <br /> �C APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> x_01 NEW PERMIT ( 1 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COPPORATION.INDIVIDUAL OR PUBLIC AGENCY) <br /> HAYRE'S EGG PRODUCERS PUBLIC AGENCY ONLY <br /> ( ) 01 FED ( ) 02 STATE ( 7 03 LOCAL <br /> STREET ADDRESS <br /> 12565 S. MANTHEY ROAD carr STATE ZIP <br /> LATHROP CA 95330 <br /> II FACILITY <br /> FACILITY NAME <br /> HAYRE'S EGG PRODUCERS DEALER/FOPEM4N/SUPERVI <br /> 74a v1 a w,b <br /> STREET ADDRESS <br /> 12565 S. MANTHEY ROAD NEAREST CROSS STREET <br /> LATHROP ROAD <br /> CITY <br /> COUNTY ZIP <br /> LATHROP SAN JOAQUIN 95330 <br /> MAILING ADDRESS <br /> 12565 S. MANTHEY ROAD CITY STATE ZIP <br /> LATHROP CA 95330 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-982-1154 ( ) 01 GASOLENE STATION (X) 02 OTHER EGG PRODUCERS <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE <br /> y ESECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> HAYRE'S EGG PRODUCERS 209-982-1154 CHARLIE'S DAY S NITE SECU 209-465-5661 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 2 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 1000 GALLONS ( 1 UNKNOWN E. DOES THE CONTAINER STORE: ( ) 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 f9O 04 DIESEL- ( 1 05 WASTE OIL ( ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> C+ <br /> A. THICKNESS OF PRIMARY CONTAINMENT: f ) GAUGE ( ) INCHES ( ) CM (X) UNKNOWN <br /> 8. ( 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( 1 01 DOUBLE WALLED (X) 02 SINGLE WALLED f ) 03 LINED <br /> 0-, ( 7 01 CARBON STEEL ( ) 02 STAINLESS STEEL f 1 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> ( ) 06 ALUMINUM (X) 07 STEEL CLAD f 1 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( 1 12 UNKNOWN ( 1 13 OTHER: <br /> HSC04-070185 (10/18/85) <br /> PAGE 1 <br />