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SU0003407 SSCRPT
Environmental Health - Public
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SU0003407 SSCRPT
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Last modified
5/7/2020 11:29:46 AM
Creation date
9/9/2019 10:10:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0003407
PE
2622
FACILITY_NAME
PA-0400137
STREET_NUMBER
15000
Direction
W
STREET_NAME
SCHULTE
STREET_TYPE
RD
City
TRACY
APN
20924025
ENTERED_DATE
4/1/2004 12:00:00 AM
SITE_LOCATION
15000 W SCHULTE RD
RECEIVED_DATE
3/31/2004 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\S\SCHULTE\15000\PA-0400137\SU0003407\SSCR RPT.PDF
Tags
EHD - Public
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STATE ID NUMBER 00000002264001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) <br /> 01 NEW PERMIT I ) 05 RENEWED PERMIT ( l 07 TANK CLOSED M\1 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT 1 ) 06 AMENDED PERMIT ( 1 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COPPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> OWENS-ILLINOIS,INC., TRACY PLA ( ) 01 FED f ) 02 STATE ( 1 03 LOCAL <br /> STPEET ADDRESS CITY STATE ZIP <br /> r� <br /> 14700 W. SCHULTE ROAD TRACY CA 95376 <br /> II FACILITY <br /> FACILITY NAME OEALER/FOREMAN/SUPERVISOR <br /> OWENS-ILLINOIS, INC. TRACY PLA ERNEST F. VALIS <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 14700 W. SCHULTE ROAD LAMMERS ROAD. <br /> CITY COUNTY ZIP <br /> TRACY SAN JOAQUIN 95376 <br /> MAILIND ADDRESS CITY STATE ZIP <br /> P.O. BOX 30 TRACY CA 95376 <br /> PHONE W/APEA CCOE TYPE OF BUSINESS <br /> 209-835-5701 ( ) 01 GASOLINE STATION (X) 02 OTHER GLASS MANUFACTURIM - <br /> NUMBER OF CONTAINERS PUPAL AREAS ONLY TOWNSHIP PA h'OE f[CTICH <br /> X <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME( LAST NAME FIRST) AND PHONE W/AP.EA CODE NIGHTS: NAME( LAST NAME FIRST) A 2 •HMNE W/AP_A CODE <br /> ERNEST F. VALIS. 209-835-5701 ERNEST F. VALIS. 209-835-8626 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINEIR <br /> IV DESCRIPTION <br /> A. ( ) 01 TANK (X) 04 OTHER: SUMP CONTAINER WA'efR 2 T_e... <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR Mf G: j({ . ( ] UNKNOWR <br /> D. CONTAINER CAPACITY: #=GALLONS [ ) UNKNOWN E. DOES THE CONTAI)" STORE: f ) 02 PRODUCT <br /> F. DOES THE CONTAINER. STORE MOTOR VEHICLE FUEL OR WASTE OIL ? c 31 YES tx):OZ NO IF YES'C34ECK APPROPRIATE BOX(ES): <br /> ( ) 01 UNLEADED t ) 02 REGULAR f ) 03 PREMIUM ( 1 04 OIESE_ 7. L 05 WASTE OIL S 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> ryIt G <br /> A. THICKNESS OF PRIMARY CONTAINMENT: 6 ( 1 GAUGE IX) INCHES '�( CM''"4 1 @i:NOF01 <br /> B. ( 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON-YAULTED v1 03 UNKNOWN <br /> Y <br /> C. [ ) 01 DOUBLE WA'_'_. (?:) 02 SINGLE WALLED ( ) 03 LINED - <br /> D.: ( 1. 01 CARBON STEEL i. ) 02 STAINLESS STEEL ( ) 03 FIBERGLASSS ),04 POLYVINYL CHLORIDE <br /> ( ) 06 ALUMINUM f 1 07 STEEL CLAD ( ) 08 BRONZE -`GJ.1.:09 COMPOSITE -I 1 10 NON-Mia'.._.!:_ <br /> t ) 12 UNKNOWN ( ) 13 OTHER: <br /> i <br /> O� 7„0185 (10/18/85) - <br /> ri;;. <br />
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