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• • STATE ID :NUMBER 00000036871003 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br /> (Xf'01 NEW PERMIT ( l 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> '!'T 02 CONDITIONAL PERMIT ( ) 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAME(COP.PORATION,INDIVIDUAL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> SAN JOAQUIN COUNTY ( ) 01 FED ( ) 02 STATE j;�-03 LOCAL <br /> STREET ADDRESS `�- CITY STATE ZIP <br /> ;7—;L2-;7—;L2- F, W C.�r STOCKTON C# 952Q2/Y <br /> II FACILITY `1 j <br /> FACILITY NAME ;�l. �•� N m-�ei 1n yY,q DEALER/FOREMAN/SUPERVISOR <br /> PETE LA PIESTO Clr✓ISOr <br /> STREET ADDRESS NEAREST CROSS STREET <br /> 1810 E HAZELTON fT 5co1q..5A f <br /> CITY COUNTY zip <br /> STOCKTON SAN JOAQUIN 95201 <br /> MAILING ADDRESS CITY STATE ZIP <br /> P.O. BOX 1810 STOCKTON CA 95201 <br /> PHONE W/APEA CODE TYPEOF BUSINESS <br /> 209-944-2291 ( ) O1 GASOLINE STATION (X) 02 OTHER <br /> NUMBER OF CONTAINERS PUPAL AREAS ONLY JTOWNSHIP SECTION <br /> 5 <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE NIGHTS: •NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> 96E;PE-LA PIESTO AG 209-944-2291 sme Nf *,htr` qy� i29' <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION. <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 3 <br /> B. MANUFACTURER (IF APPROPRIA'T'E/): UNKNOWN YEAR MFG: C. YEAR INSTALLED (X) UNKNOWN <br /> D. CONTAINER CAPACITY: ' 9999=GALLONS ( ) UNKNOWN E. DOES THE CONTAINER STORE: ( I 01 WASTE (X) 02 PRODUCT <br /> F. DOES THE CONTAIVEHICLE FUEL OR WASTE OIL ? (X) 01 YES ( l 02 NO IF YES CHECK APPROPRIATE BOX(ES): <br /> ( ) <br /> 01 UNLEADEylllllllk ( ) 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 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED Ul 02 SINGLE WALLED ( l 03 LINED <br /> D. 06 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( l 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( l 06 ALUMINUM ( l 07 STEEL CLAD ( l 08 BRONZE ( l 09 COMPOSITE ( ) 10 NON-METALLIC <br /> 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> � i <br />