Laserfiche WebLink
`,NIFIEO PROGRAM CONSOLIDATED SRM <br /> TANKS <br /> UNDERGROUND STORAGE TANKS - FACILITY 0 <br /> 1"'Dwilw3i <br /> TYPECFACTICN 01.NEW sREPERMIT ❑1 RENEWAL PERMIT IIIW im+ANG'c OF RMATION(SPa 'o4enp- }a.Z PERMANENRY CIC5EO8RE :��.ZG"/-!. <br /> fCI1wloM nbrll o.lu.oWYl 08.TANK REMOVED 800 <br /> C1 4 AMENDED PERMIT <br /> ❑ 8.'EMPORAAY SITE CLOSURE <br /> � I.FACILfTY I SITE INFORMATION <br /> BUSWESS NAME($+nu u FACILITY NAY DBA-0.r 9iM. • ] FACILITY 10 e 1 <br /> San Joaquin Mosquito & Vector Control District - <br /> NEARESTCROSSSTREET wt FACIUTY OWNER TYPE 08. LOGLAGENCYRASTRIGi' <br /> Stimpson Street CoaFORAT10N ■i <br /> C°u"'-YAoeIO'' <br /> ❑ L INDIVIW 0 5. STATEAGEHCY' <br /> BUSINESS 0 I.GAS STATION 0].FARM ❑ S COMMERCLL 0 1 PARTNERSHIP 0 i. FEDERAL AGENCr 802 <br /> PE <br /> ❑ i DISTRIBUTOR ❑].PROCESSOR E OTHER 801 <br /> -OTARI MBEROF TANKS HMRIT an mY.RABIMtim or 'tlo.W of USTapbleeONK:(RrPB olawwv of <br /> REMAIWNG AT SREo-uma�T (TlO.u�e�p�eWrore�urtMnm UST. <br /> Nae <br /> 2 'B' 73 Y. QNo as John Stroh <br /> 1.PROPERTY OWNER INFORMATION <br /> NBT PHONE Nae <br /> PROPERTY OWNER NAME <br /> San Joaquin County Mosquito & Vector Control District 800-300-4675 <br /> as <br /> MAg1NG OR STREET ADDRESS <br /> 7759 South Airport Way .126,0 <br /> STATE <br /> tll P E <br /> Stockton CA 95206 <br /> PROPERTY OWNER TYPE L INOMOINL 0 e. LOCALAGENf.YID6neCT ❑ B.STATE AGENCY e11 <br /> ❑ I. CCRPORATICN ❑1 PARTNERSHIP S.COUNTY AGENCY ❑ T. FEDERALAGENCY <br /> III.TANK OWNER INFORMATION <br /> 81A PHONE 815 <br /> TANK D ER NAME <br /> San Joaquin County Mosquito & Vector Control District 800-300-4675 <br /> ne <br /> "UNG OR STREET ADDRESS <br /> 7759 South Airport Way _ ,19 <br /> 411 418 ➢P CGDE <br /> Stockton CA 95206 <br /> TANK OWNER TYPE 0 L INo VssM 0 8.LOCAL AGENCY I DISTRICT 0 6 SfATEAGENCY e]B <br /> ❑ 1. CCRPORAToN ❑ 1 PARTNERSHIP M i COUNTY AGENCY C 1 �EMRALAGENCY <br /> TV.BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER <br /> TY(TIC)HQ 4 4 Cal(916)322-9669 if queslom arise X31 <br /> V. PETROLEUMUST FINANCIAL RESPONSIBILITY <br /> uN01 Ire MEMO= 0 1. sEwNsUREO 0 e. SURETYBpNO 0 T.STATE FWO ® 10. LGCALGOVTMECItM&SM <br /> 0 i G RANTEE 0 i LETTER�CRETIT 0 6 STATEFIfOLCFOLETTER Cl W.OTHER M <br /> 0 1 INSURANCE Cl d E%EM m ❑s. STAT mw&CO <br /> VL LEGAL NOTIFICATION AND MAILING ADDRESS- <br /> CgNelo,r Omm�NIr W11M1 MII\.N1Otl M.tl bMVN lRobuwM ne meiK ❑ 1.FACALM ®1 PROPETTTY OVMEA ❑ 1 TAW amaER 40 <br /> LqI IMdOWratl mrW,98-1E M NIK m tlr YLAf O'ttM1.�5m1 t ora u QMQALL <br /> VII.APPLICANT SIGNATURE <br /> CNINFeEIe ILa1V/tW Br BI�ION NtlamNe mer er o/nry RnRlMBpe. <br /> S, E OF DATE RA PHONE 4z <br /> i <br /> r-as owner agent 4/13/00 - 2- <br /> CFAPRICA6T(PIJ 136 TRLEOFAPRICANT <br /> Barry E. Edmiston Administrative Assistant <br /> ST�USTFKIUTY NUMBER(FarwolurlM <br /> A3B ,ws Wrd+woE CETRFKaATE NIlYBER(ForAi1l�i I,IY! '� <br /> 3 3T <br /> 1/l� <br /> UPCF(1/99) <br /> FarmsM SWRCB Tam A <br /> •Ar 499y <br />