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ISTAT£ ID NUMBER 00000008286001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> 1 01 NEW PERMIT ( 1 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE3 <br /> ( 3 <br /> 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT { 1 08 MINOR CHANGE (NO SURCHARGE) <br /> OWNER <br /> AM:(COPPCPATICN.ZNDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> WESTERN LUMBER SALES OF STOCKY E 1 OI FED ( 1 02 STATE E l 03 LOCAL <br /> rPEET ADDRESS CITY STATE ZIP <br /> 422 S. EL DORADO-PO BOX 1848 STOCKTON CA 95201 <br /> I �aczLZTY ' <br /> - T WESTERN LUMBER SALES ITY DEAL ER/F0099AN/SUPERVISOR <br /> RON KOROCK - f� <br /> TPEET ACORE5S <br /> NEAREST CROSS STREET <br /> 422 S. EL DORADO MC KINLEY <br /> C;-Y <br /> COUNTY ZIP <br /> TOCKTDN SAN 1OAQUIN 95206 <br /> A:L:%Q ACDRSSS CITY STATLIP <br /> 0 SOX 1848 STOCKTON CA 95201 <br /> r0CM! W/APEA CCCE TYPE OP BUSINESS <br /> 09-982-4477 f l 01 GASOLINE STATION (X) 02 OTHER L(jT18ER CO. <br /> VUr5lff ^.• G04TAIVERS PUPAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> 1 <br /> II 24 HOUR EMERGENCY CONTACT PERSON <br /> Nf('E(LAST VAM! FIRST) AND PHONE W/AREA CODENIGHTS NA(RE(LAST NAME r%RST) AND P`0ME W/AREA CODE <br /> K. RON 209-982-4477 KOROCK. RON 209-951-4759 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> DESCRIPTION <br /> (X) 01 TANK ( 1 04 OTHER: CONTAINER NUMBER W-1 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C YEAR INSTALLED (X1 UNKNOWN <br /> ICONTAINER CAPACITY 2000 GALLONS ( ) UNKNOW7N E DOES THE CONTAINER STORE i 1 01 WASTE (X) 02 PRODUCT <br /> F DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR BASTE OIL ' (XI al YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( f 01 UNLEADED (x) 02 REGULAR ( 1 03 PREMIUM IW04 DIESEL { f 05 WASTE OIL t ) 06 OTHER <br /> r CONTAINER CONSTRUCTION <br /> THICKNESS OF PRIMARY CONTAINMENT: ( 1 GAUGE ( ) INCHES ( 1 CM (X) UNKNOWN <br /> ( 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> 01 DOUBLE WALLED (X) 02 SINGLE WALLED ( 1 03 LINED <br /> 01 CARBON STEEL ( 1 02 STAINLESS STEEL ( J 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( 1 09 COMPOSITE { ) IQ NON-METALLIC <br /> 12 UNKNOWtj ( ) 13 OTHER: <br /> t04-070185 {10/18/851 PAGE 1 <br />