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ILE <br /> 6 <br /> TE ID NUMBER 00000047797006 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> 01 NFn PERMIT ( ) 05 RENEWED PERMIT ((q 07 TANK CLOSED (�q 09 DELETE FROM FILF_)tin c� <br /> t 1 02 60NDITIONAL PERMIT ( ) 06 AMENDED PERMIT MINOR CHANGE (NO SURCHARGE)) <br /> I OWNER <br /> N-Ili--(CORPOP.ATION,INDIVIDUAL OR PUBLIC AGENCY) F(UB)LIOC, <br /> AGENCY ONLY <br /> TEXACO U.S.A. FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> P.O. BOX 3756-3350 WILSHIRE BL LOS ANGELES CA 90010 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> TEXACO CONTRACTOR OPERATED <br /> STREET ADOPESS NEAREST CROSS STREET <br /> 440 W. CHARTER WAY & LINCOLN <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95206 <br /> MAILING ADCFESS CITY STATE ZIP <br /> 440 W. CHARTER WAY &LINCOLN STOCKTON CA 95206 <br /> PHONE W/APEA CODE TYPE OF BUSINESS <br /> 209-943-9319 (X) 01 GASOLINE STATION ( ) 02 OTHER <br /> NUMBER. OF CONTAINERS RURAL AREAS ONLY : TOWNSHIP RANGE SECTION <br /> 6 N/A N/A N/A <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME tLAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> TEXACO USA CUSTOMER SERVI 800-231-3102 HEINRICH, DAVID 916-966-3790 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 6 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED 1960 ( ) UNKNOWN <br /> D. CONTAINER CAPACITY: 550 GALLONS ( l UNKNOWN E. DOES THE CONTAINER STORE: (X) 01 WASTE ( ) 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 ( 1 02 REGULAR ( l 03 PREMIUM ( ) 04 DIESEL (X) 05 WASTE OIL ( ) 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. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( 1 09 COMPOSITE ( 1 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />