Laserfiche WebLink
F I <br /> STATE ID NUMBER 00000018453002 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> � 01 NEW PERMIT { 1 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ! 09 DELETE FROM FILE (NO FEE) <br /> l 02 CONDITIONAL PERMIT ( 1 06 AMENDED PERMIT ( 1 08 MINOR CHANGE (NO SURCHARGE) I <br /> F: <br /> OWNER - <br /> ::7c(C0;POP.A;ION.:NDSVIOUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> IrRGY PETROLEUM INC- i ) 91 FED ( 1 02 STATE ( ) 03 LOCAL <br /> �- <br /> e D CITY STATE Zip <br /> T �.-D=ESS �, <br /> -ROAD -2'_—L-tt 4 STOCKTON CA;. 95203 <br /> FACILITY w <br /> %CI:ITY NAME CEALER/FOREMAN/SUPERVISOR - <br /> IERGY PETROLEUM INC. <br /> h 'ET ?vDP.,55 n' i� NEAREST CROSS STREET <br /> ROAD et—&'•Tt <br /> (O I <br /> COUNTY ( 'ZIP <br /> i :KTON ISAN JOAQUIN 95203 <br /> %:LING ADDRESS CITY STATE ZIP' . <br /> n. <br /> BOX 744 STOCKTON CA 95201 <br /> �. _ . <br /> + 4 <br /> :E W/AREA CCDE TYPE OF 'BUSINESS <br /> 39-464-4886 ( ) 01 GASOLINE STATION (X) 02 OTHER WHOLESALE <br /> a <br /> SER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> ! i <br /> 4 <br /> TT 24 HOUR EMERGENCY CONTACT PERSON <br /> S: NA-IE(LAST NAME F RST) AND PHONE W/APEA CODE NIGHTS: NAMECLAST NAME FIRST') AND PHONE W/AREA CODE <br /> LARM SYSTEM Ce 204-464-4886 SAME <br /> LCOMPLETE THE FOLLOWING ON A SEPARATE FORW FOR EACH CONTAINER • � <br /> V DESCRIPTION <br /> LX) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 2 <br /> MANUFACTURER EIF APPROPRIATE) YEAR MFG: C. YEAR INSTALLED 1975 t } UNKNOWN ' <br /> CONTAINER CAPACITY: 12000 GALLONS E ) UNKNOWN E. DOES THE CONTAINER STORE: [ } 01 WASTE 'I X) 02-PRODUCT <br /> DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (X) 01 YES . („ ) 02 NO IF YES CHECK APPROPRIATE 5OX(ES1 <br /> E ) 01 UNLEADED EX) 02 REGULAR ( l 03 PREMIUM_( ) 04 DIESEL ( )' 05 WASTE OIL [ ) 06 OTHER -h � <br /> CONTAINER CONSTRUCTION <br /> THICKNESS OF PRIMARY CONTAINMENT (. 1 GAUGE ( ] INCHES ( }. CM MUNKNOWN <br /> IL } 01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (XI 02 NON-VAULTED ( .I 03 UNKNOWN V <br /> i <br /> :�( l O1 DOUBLE WALLED i ) 02 SINGLE WALLED ( ) 03 LINED .. � <br /> 1�( 1 O1 CARBO)) 5TEEL ( ] 02 STAINLESS STEEL ( )'03 FIBERGLASS ["104 POLYVINYL CHLORIDE ( f�05 CONCRETE <br /> ( ) 06 ALUMINUM ( } 07 5TEEL CLAD ( !. 0$ BRONZE ( ) 09 COriPOSITE t ) 10 NON-METALLIC M1 f <br /> ;64-070185 <br /> 4-070185 (10/18/85) PAGE 1 <br /> L <br /> f ' <br />