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STATE ID NUMBER 00000006268002 <br />APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TANK <br />01NEWPERMIT (') 05 RENEWED PERMIT' t ) 07 TANK CLOSED t ) 09 DELETE FROM FILE (NO FEE) <br />t D 02 O TIONAL,PERMIT ( J 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br />I OWNER <br />NAME(CCPPOP.ATION,INDIVIDUAL':OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br />QUIK STOP MARKETS INC ( ) 01 FED ( J 02 STATE t ) 03 LOCAL <br />STREET ADDRESS CITY STATE ZIP <br />4567 ENTERPRISE ST FREMONT CA 94538 <br />Ii FACILITY <br />FACILITY NAME <br />(X) 01 TANK ( ) 04 OTHER: <br />DEALER/FOREMAN/SUPERVISOR <br />QUIK STOP #39 <br />NUMBER 13 <br />WOO CHUN <br />STREET ADDRESS <br />Y€AR'MFG: <br />NEAREST CROSS STREET <br />2285 E. FREMONT <br />D. <br />E ST <br />CITY <br />€. GOES THE CONTAINER STORE: t <br />COUNTY <br />ZI-P <br />STOCKTON <br />FUEL OR WASTE OIL ? (X) 01 YES ( ) 02 NO <br />PREMIUM ( ) 04 DIESEL I ) 05 WASTE OIL <br />SAN JOAQUIN <br />95025 <br />MAILING ADDRESS <br />103 FIBERGLASS t l 04 <br />CITY <br />STATE <br />ZIP <br />PO BOX 5745 <br />BRONZE ( ) 09 COPtPOSITE <br />FREMONT <br />CA <br />94537 <br />PHONE W/:4PEA CODE <br />TYPE OR BUSINESS <br />204-464-1038 <br />(X) 01 GASOLINE STATION f D 02 OTHER <br />NUMBER OF CONTAINERS <br />RURAL AREAS ONLY <br />TOWNSHIP <br />RANGE <br />SECTION <br />2 <br />IIT 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 />CHUN, WOO 209-464-1038 CHUM, WOO 209-369-3773 <br />COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br />IV DESCRIPTION <br />A. <br />(X) 01 TANK ( ) 04 OTHER: <br />CONTAINER <br />NUMBER 13 <br />B. <br />MANUFACTURER (IF APPROPRIATE): <br />Y€AR'MFG: <br />C. <br />YEAR INSTALLED 1972 d ) UNKNOWN <br />D. <br />CONTAINER CAPACITY: 10000 GALLONS t <br />) UNKNOWN <br />€. GOES THE CONTAINER STORE: t <br />) 01 WASTE (X) 02 PRODUCT <br />F. <br />DOES THE CONTAINERSTORE MOTOR VEHICLE <br />(X) 01 UNLEADED ( ) 02 REGULAR ( ) 03 <br />FUEL OR WASTE OIL ? (X) 01 YES ( ) 02 NO <br />PREMIUM ( ) 04 DIESEL I ) 05 WASTE OIL <br />IF YES CHECK APPROPRIATE BOX(ES): <br />t ) 06 OTHER <br />V CONTAINER CONSTRUCTION <br />0 <br />A. <br />'THICKNESS OF PRIMARY CONTAINMENT: <br />t D GAUGE ( ) INCHES ( <br />) CM' (X) UNKNOWN <br />B. <br />( D <br />01 VAULTED (LOCATED IN AN UNDERGROUND VAULT) (X) 02 NON -VAULTED ( <br />) 03 UNKNOWN <br />C. <br />C ) <br />01 DOUBLE WALLED (X) 02 SINGLE WALLED 4 <br />D 03 LINED <br />D. <br />(X) <br />01 CARBON STEEL t D 02 STAINLESS STEEL ( <br />103 FIBERGLASS t l 04 <br />POLYVINYL CHLORIDE t ) 05 CONCRETE <br />t ) 06 ALUMINUM { D 07 STEEL CLAD C ) 08 <br />BRONZE ( ) 09 COPtPOSITE <br />t ) 20 NON-METALLIC <br />C ) <br />12 UNKNOWN ( ) 13 OTHER: <br />