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�.. 0(�').•L+�� '%W STATE I0 NUMBER 00000010752001 <br /> APPLICATION FOR PERMIT TO OPERAT U DERGROUND STORAGE TANK <br /> f 1 01 NEW PERMIT ( ) 05 RENEWED PERMIT NK C ( 1 09 DELETE FROM FILE (NO FEE) <br /> f 1 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT ( 1 08 M ANGE (NO SURCHARGE) <br /> I OWNER <br /> NAMEICO-POPATION.INDIVIOUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> PETERSON MFG. CO. SUBSIDIARY K ( ) 01 FED ( ) 02 STATE ( 1 03 LOCAL <br /> STFEET ADDRESS CITY STATE ZIP <br /> 2626 E. 25TH ST LOS ANGELES CA 90058 <br /> II FACILITY <br /> FACIL^Y N=ME DEALER/FOREMAN/SUPERVISOR <br /> (PETERSON MFG. CO. HARVEY ALLEN <br /> STREET ADOPESS NEAREST CROSS STREET <br /> 2403 NAVY DRIVE FRESNO <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95206 <br /> MAILING ACDPESS CITY STATE ZIP <br /> 2403 NAVY DRIVE STOCKTON CA 95206 <br /> PHONE W'APEA CODE TYPE OF BUSINESS <br /> 209-462-5818 ( ) 01 GASOLINE STATION (X) 02 OTHER RENDERING <br /> NUMBER 0' CONTAINERS PUPAL AREAS ONLY TOWNSHIP RANO! SECTION <br /> 1 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAM,E(LAST NAME FIRST) AND PHONE Wi AREA CODE NIGHTS: NAME(LAST NAME FIRST) ANO PHONE W/AREA COO! <br /> ALLEN. HARVEY 209-462-5818 ALLEN. HARVEY 209-957-4664 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 18 <br /> B. MANUFACTURER, (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 1000 GALLONS ( 1 UNKNOWN E. DOES THE CONTAINER STORE: ( ) 01 WASTE (X) 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 /> (X) 01 UNLEADED f 1 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( 1 05 WASTE OIL ( 1 06 OTHER <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: f ) GAUGE ( ) INCHES f 1 CM (X) UNKNOWN <br /> B. ( 1 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) ( ) 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( 1 02 SINGLE WALLED ( ) 03 LINED <br /> 0. f 1 01 CARBON STEEL ( 1 02 STAINLESS STEEL ( 1 03 FIBERGLASS ( 1 04 POLYVINYL CHLORIDE ( 1 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD f ) 08 BRONZE f 1 09 COMPOSITE ( 1 10 NON-METALLIC <br /> (XI 12 UNKNOWN ( 1 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> �1 w/ i <br />