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BILLING_PRE 2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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PACIFIC
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6425
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2300 - Underground Storage Tank Program
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PR0231211
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BILLING_PRE 2019
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Entry Properties
Last modified
12/4/2023 2:51:21 PM
Creation date
5/15/2019 9:33:29 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0231211
PE
2371
FACILITY_ID
FA0002409
FACILITY_NAME
SAFEWAY FUEL CENTER #2707
STREET_NUMBER
6425
Direction
N
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
01
SITE_LOCATION
6425 N PACIFIC AVE
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
KBlackwell
Tags
EHD - Public
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STATE ID NUMBER 00000012290002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> 11t IJFLL�GOMT <br /> T ( 7 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(COP.POPATION.INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> WICKLAND OIL CO. ( ) 01 FED ( ) 02 STATE X) 03 LOCAL <br /> STREET ADDEESS CITY STATEZIP <br /> 1765 CHALLENGE WAY SACRAMENTO CA 95815 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> REGAL STATION #603 WALT SNELLING <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 6425 PACIFIC AVE. DOUGLAS <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95207 <br /> MAILING ADDRESS CITY STATE ZIP <br /> 1765 CHALLENGE WAY SACRAMENTO CA 95815 <br /> PHONE W/AREA CODE TYPEOF BUSINESS <br /> 916-921-1100 (X1 01 GASOLINE STATION ( ) 02 OTHER <br /> NUMBER OF CONT SNE P,S RURAL AREAS ONLY TOWNSHIP RANGE SECTION <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 /> STEVEN K. LEWIS 916-921-1100 <br /> XC Z <br /> y <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 603-R1 <br /> B. MANUFACTURER (IF APPROPRIATE): UN YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 10000 GALLONS ( ) UNKNOWN E. DOES THE CONTAINERSTORE: [ l 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (XI 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES1: <br /> ( ) Ol UNLEADED (X) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( ) 05 WASTE OIL 1 ) 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 1/4 l ) GAUGE (X) INCHES ( ) CM f l 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 ( 1 03 LINED <br /> 0. (X) 01 CARBON STEEL ( 1 02 STAINLESS STEEL f 1 03 FIBERGLASS f ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ' ( ) 06 ALUMINUM ( 1 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE ( ) 10 NON-METALLIC <br /> ( 1 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />
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