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STATE ID NUMBER 00000027845001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> ( ) <br /> 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( 1 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> ( ) 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NA`7E(CC=FCEATICN,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> TRACY DELTA SOLID WASTE MANAGE ( ) 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> STREET A,ODPESS CITY STATET95376 <br /> 99 W 6TH STREET, P.O. BOX 274 TRACY CA <br /> II FACILITY - <br /> FACILITY NAME DEA <br /> TRACY DISPOSAL SERVICE DAN <br /> STREET ADDPESSN E F <br /> 99 W 6TH STREET g <br /> CITY COL O <br /> TRACY SAP '�� <br /> M.-ILI�:3 ACDPESS CITY <br /> P.O. BOX 274 TRACY 76 <br /> PHONE W/AFE.A CCDE TYPE OF BUSINESS <br /> 209-835-0601 ( ) 01 GASOLINE STATIOP <br /> NlJMBE-r. OF CONTAINERSRUP.AL AREAS ONLY TOWNSHIP <br /> 2 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: N.Z.ME(LA.ST NAME FIRST) AND PHONE W/AREA CODE NIC :ODE <br /> ROBERTS, BEN M. 209-835-2145 SAME- - - <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 1 <br /> IB. MANUFACTURER (IF APPROPRIATE)= YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 550 GALLONS ( ) UNKNOWN JE. 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 /> ( ) 01 UNLEADED (X) 02 REGULAR ( ) 03 PREMIUM ( ) 04 DIESEL ( ) 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) ( ) 02 NON-VAULTED (X) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED ( ) 03 LINED <br /> D• ( ) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( l 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE ( l 10 NON-METALLIC <br /> (X) 12 UNKNOWN ( ) 13 OTHER: t <br /> SC04-070185 (10/18/85) PAGE 1 <br />