Laserfiche WebLink
VeMo0�-9 <br /> • STATE Ill NUMBER 00000029713002 <br /> t APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> (� 01 NEW PERMIT ( 1 05 RENEWED PERMIT (X) 07 TANK CLOSED k) 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT [ ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(CORPOPATION.INOIVL0_UAL OR PU LIC A NCY) PUBLIC AGENCY ONLY <br /> �e +^�• `C(GCF r- COr ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 19901 $0. MCHENRY AVENUE ESCALON CA 95320 <br /> II FACILITY <br /> FACILITY NAME DEI R/FOREMAN/SUPER ISOR <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 19901 SO. MCHENRY AVENUE CLOUGH AVENUE <br /> CITY COUNTY ZIP <br /> ESCALON SAN JOAQUIN 95320 <br /> MAILING ADDRESS CITY STATE ZIP <br /> P.O. BOX 67 ESCALON CA 95320 <br /> PHONE W/AREA CODE TYPE OF BUSINESS <br /> 209-838-3564 ( ) 01 GASOLINE STATION (X) 02 OTHER FRESH FRUIT PROCESSI <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 4 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> GAYS: NAMEt LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST] AND PHONE W/AREA CODE <br /> 209-838-3809 MARtIH-t*F* GA 209-83Ar38B9- <br /> � =MPLETE THE FOLLOWING ON A SEPAR ET�OR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 2 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: 1978 C. YEAR INSTALLED 1978 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 10000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE fX) 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 OM 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL [ ) 05 WASTE OIL f 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( ) INCHES ( ) CM (X) 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., ( ) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( 1 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( l 05 CONCRETE <br /> ( ) 06 ALUMINUM (X) 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> i ) 12 UNKNOWN ( ] 13 OTHER: <br /> HSCO4-070185 (10/18/85) PAGE 1 <br />