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0 0 <br /> STATE ID NUMB" <br /> 00000013072001 <br /> APPLICATION FOR PERMIT TO OPERATE UNDERGROUND STORAGE TAN _ <br /> 01 NEW PERMIT ( ) 05 RENEWED PERMIT ( ) 07 TANK CLOSED ( ) 09 DELETE FROM FILE (NO FEE) <br /> 1 02 CONDITIONAL PERMIT ( l 06 AMENDED PERMIT ( ) 08 MINOR CHANGE (NO SURCHARGE) <br /> I OWNER <br /> NAI',E(COPPORATICN,INDIVIDU.AL OR PUBLIC AGENCY) PUBLIC AGENCY ONLY <br /> CALIFORNIA WATER SERVICE CO. ( ) 01 FED ( ) 02 STATE [ ) 03 LOCAL <br /> STREET ADDRESS CITY STATE ZIP <br /> 1720 N. FIRST STREET SAN JOSE ICA 95112 <br /> II FACILITY <br /> FACILITY NAME DEALER/FOREMAN/SUPERVISOR <br /> STA. 1-F STOCKTON M.E. CAMYi MANAGER <br /> STREET ADDRESS NEAREST CROSS STREET <br /> *MD sume" <br /> CITY COUNTY ZIP <br /> STOCKTON SAN JOAQUIN 95202 <br /> MAILING ADDRESS CITY STATE ZIP <br /> llli N0. EL DORADO ST. STOCKTON CA 95202 <br /> PHONE W/.AREA CODE TYPE OF BUSINESS <br /> 209-466-8971 ( l 01 GASOLINE STATION (X) 02 OTHER AUX. ENGINE <br /> NUMBER OF CONTAINERS RURAL AREAS ONLY TOWNSHIP RANGE SECTION <br /> III 24 HOUR EMERGENCY CONTACT PERSON <br /> DAYS: NAME LAST NAME FIRST) AND PHONE W/AP.EA CODE NIGHTS: NAME(LAST NAME FIRST) AND PHONE W/AREA CODE <br /> M.E. CAMY 209-4i4-&YPr _g M.E. CAMY .20944 8-&rW <br /> Ito <br /> COMPLETE THE FOLLOWING ON A SEPARATE FORM FOR EACH CONTAINER <br /> IV DESCRIPTION <br /> A. (X) 01 TANK ( ) 04 OTHER: CONTAINER NUMBER 2 <br /> B. MANUFACTURER (IF APPROPRIATE): YEAR MFG: C. YEAR INSTALLED 1958 ( l UNKNOWN <br /> D. CONTAINER CAPACITY: 350 GALLONS ( ) UNKNOWN E. 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) (X) 02 NON-VAULTED ( ) 03 UNKNOWN <br /> C. ( ) 01 DOUBLE WALLED ( ) 02 SINGLE WALLED t l 03 LINED <br /> D. (X) 01 CARBON STEEL ( ) 02 STAINLESS STEEL ( ) 03 FIBERGLASS ( ) 04 POLYVINYL CHLORIDE ( ) 05 CONCRETE <br /> ( ) 06 ALUMINUM ( ) 07 STEEL CLAD ( ) 08 BRONZE ( ) 09 COMPOSITE ( l 10 NON-METALLIC <br /> ( ) 12 UNKNOWN ( ) 13 OTHER: <br /> HSC04-070185 (10/18/85) PAGE 1 <br /> i • <br />