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`. *400 <br />STATE ID NUMBER 00000013932005 <br />APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAnF TANK <br />(Al'01 NEW PERMIT f ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( 1 09 DELETE FROM FILE (NO FEE) <br />( ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br />I OWNER <br />IAME(CORPOPATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br />!. W. L. INVESTMENTS, INC. f ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br />'TREET ADDRESS CITY STATE ZIP MARIPOSA STREET SAN FRANCISCO CA 94107 <br />II FACILITY <br />FACILITY NAME <br />(X) 01 TANK ( ) 04 OTHER: <br />DEALER/FOREMAN/SUPERVISOR <br />CONTAINER NUMB 04 <br />DI SALVO TRUCKING CO. <br />MANUFACTURER (IF APPROPRIATE): U/N <br />GEORGE MUNSON, TERMINAL MANAGE <br />C. YEAR INSTALLED (X) UNKNOWN <br />STREET ADDRESS <br />CONTAINER CAPACITY -12000 G LLONS ( 1 UNKNOWN <br />NEAREST CROSS STREET <br />F. <br />1444 LATHROP ROAD <br />( ) 01 <br />( ) <br />(X) 12 <br />CARBON STEEL <br />06 ALUMINUM [ <br />UNKNOWN ( ) 13 <br />( ) 02 STAINLESS STEEL ( <br />) 07 STEEL CLAD ( ] 08 <br />OTHER: <br />CITY <br />COUNTY <br />IIP <br />LATHROP <br />SAN JOAQUIN <br />95330 <br />MAILING ADDRESS <br />CITY EE] <br />P.O. BOX 3765 <br />SAN FRANCISCO <br />STATE <br />CA <br />IIP <br />94119 <br />PHONE W/AREA CODE <br />TYPE OFBUSINESS <br />209-858-2531 <br />[ ) O1 GASOLINE STATION (X) 02 OTHER <br />NUMBER OF CONTAINERS <br />RURAL AREAS ONLY <br />TOWNSHIP <br />RANGE <br />SECTION <br />7 <br />III 24 HOUR EMERGENCY CONTACT PERSON <br />'AYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br />IUNSON, GEORGE 209-858-2531 pAy§MrO�Nm,�,_ <br />ITP <br />COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br />IV DESCRIPTION <br />A. <br />(X) 01 TANK ( ) 04 OTHER: <br />CONTAINMENT: <br />CONTAINER NUMB 04 <br />B. <br />MANUFACTURER (IF APPROPRIATE): U/N <br />YEAR MFG: <br />C. YEAR INSTALLED (X) UNKNOWN <br />D. <br />CONTAINER CAPACITY -12000 G LLONS ( 1 UNKNOWN <br />E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 02 PRODUCT <br />F. <br />DOES THE CONTAINER TOR VEHICLE FUEL OR W 01 YES ( l 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. <br />THICKNESS OF PRIMARY <br />CONTAINMENT: <br />f l GAUGE f ) INCHES f 7 CM (X) UNKNOWN <br />B. <br />f 1 01 <br />VAULTED (LOCATED IN AN UNDERGROUND VAULT) 2 NON -VAULTED 4lM'13 UNKNOWN <br />C. <br />f 1 01 <br />DOUBLE WALLED(:(!')2 <br />SINGLE WALLED f <br />1 03 LINED <br />D. <br />( ) 01 <br />( ) <br />(X) 12 <br />CARBON STEEL <br />06 ALUMINUM [ <br />UNKNOWN ( ) 13 <br />( ) 02 STAINLESS STEEL ( <br />) 07 STEEL CLAD ( ] 08 <br />OTHER: <br />) 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br />BRONZE ( 1 09 COMPOSITE ( ) 10 NON-METALLIC <br />naau4-Y2VA6D 21U/12121!1 <br />PAGE 1 <br />