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STATE ID NUMBER 00000037709003 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> (X) 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 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 /> NAME(CORPORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> SHARPE ARMY DEPOT t 01 FED ( ) 02 STATE ( ) 03 LOCAL <br /> ---J <br /> STREET ADDRESS CITY STATE ZIP <br /> ROTH ROAD LATHROP CA 95331 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> SHARPE ARMY DEPOT <br /> STREET ADDRESS NEAREST CROSS STREET <br /> ROTH ROAD <br /> CITYCOUNTY ZIP <br /> LATHROP SAN JOA(PUIN 95331 <br /> MAILING ADDRESS CITY STATE ZIP <br /> ROTH ROAD LATHROP CA 95331 <br /> PHONE 209-982/2641 CODE TYPE OF BUSINESS <br /> 01 GASOLINE STATION (, 02 OTHER d(!A e, <br /> i <br /> NUMBER 0'f CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> is 6E 23 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LA.ST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> 209-982-2641 ACTING FIRE CHIEF 209-982-2105 <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 657-1 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: 1000 GALLONS t ) UNKNOWN JE. DOES THE CONTAINER STORE: { ) 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAINER STORE MOTOR VEHICLE FUEL OR WASTE OIL ? (XJ 01 YES ( ) 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> 01 UNLEADED t ) 02 REGULAR t ) 03 PREMIUM ( D 04 DIESEL t ) 05 WASTE OIL (X) 06 OTHER AVIATION FUEL <br /> V CONTAINER CONSTRUCTION <br /> A. THICKNESS OF PRIMARY CONTAINMENT: ( ) GAUGE ( J 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 t l 03 LINED <br /> 0. (X) 01 CARBON STEEL t ) 02 STAINLESS STEEL ( } 03 FIBERGLASS E ) 04 POLYVINYL CHLORIDE E ) 05 CONCRETE <br /> f ) 06 ALUMINUM i D 07 STEEL CLAD E ) 08 BRONZE t ) -09 COMPOSITE t J 1`0 NON-METALLIC <br /> ( l 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br />