Laserfiche WebLink
From: Bryce Ruschhoupt To: Magpie Oale: 10/11/95 Time: 15:07:52 Pape 2 of 2 <br />v <br />ENVIRONMENTAL HEALTH DIVISION <br />APPUCATION FOR UNDERGROUND TANK INSTA"TION PERMIT <br />APPLICATION FOR IMIFFALLATION OF UVOkNcRol)p TAMKK ARE ONLY VAL0 FOR TME CALENDAR YEAR IN HNICH ET SAS BEES [3itfE0, <br />A PERMIT MAY RE EMTRNOED INTO THE VEST MANDAN YEAR IF A LETTER IS SW TO P".Dl) REOUESTSAG THIS EXTENSION! THIRTY DAYS <br />PRIOR TO THE END OF THE CALENDAR TEAR. A ME YEAR -- ONE TIME EXTENBUCIS MAY BE CIAMrED Ry 113 -EMD UPON RECEIPT OF TBI& LETTER. <br />00 Nor (RITE IM ANY SHADED AREAS. <br />EPA SITE 0 PROJECT CONTACT & TELEPMTJIE N <br />Rick Garrett 510-842-9178 <br />F FACILITY LARNE Chevron USA Station #9-8264 <br />A PHOME IT 209.836 2119 <br />C AODRE55 3775 Tracy Blvd. Tracy Ca. <br />I <br />L CROSS STREET Larch Road — <br />I <br />ORPERA <br />cR/OTOR <br />T Chevron USA PO Box 5004 San Ramon Ca. 94583 <br />PHONE P <br />510.0d2-0500 <br />C CONTRACTOR NAME California Petroleum Equipment Inc. <br />o --__ <br />PROSE R 209-2761881 <br />R CONTRACTOR Ron"" PO Box 9364 Fresno Ca. 93792 CA LIC N <br />T 432613 <br />CT A$6 A, B. C61 -D40 <br />A MZARODIS UASTE CERTIFIED TES X ND 1OONK.cplp.f 104800.' 94 <br />A <br />C FIRE DISTRICT <br />r PERMIT A <br />0 BOAFD OF EQUALIZATION B <br />10 0 TAME SIIE CHEMICALS TO BE STORED PROPOSED INSTALLATION <br />19- 12,006 Gal <br />Regular Unleaded 11-95 <br />IFATANK <br />72000 Gal us Unlee �,-iATE <br />A �- <br />Gal <br />■ 39- <br />_ Su Unleaded <br />K 39- <br />34- <br />39- <br />p Bill iifiiTllifi1f11eFifl <br />L APPROVED APPROVED MYTH CCNDITION(T) DISAPPBOYEO <br />A —� <br />ATTACMMEVT <br />I WITH CON DITIONS) <br />N f2AB REVIFHER6 NAME GATE <br />11111111]HIIIilltll 11111 <br />APPLICANT MIST PERFORMS ALL NRK IN ACCORDANCE WITH SAH JOADU[H COUNTY ORDINANCES, STATE LAMS, AND RULES AND REGULATIONS OF <br />SIM JOAQUIN IDMNIrT PUBLIC HEALTH SERVICES. COMER OR LICERSED AGENT,R StCMATURE CERTIFIES THE FOLLOWING: ^1 CERTIFY THAT IN <br />TME PERFORMANCE OF THE WORK FOR WNICN THIS PERMIT ES 133IND, 1 SHALL HOT ENPLOT ANY PERSON LV SUCH A MANNER AS TO NECONE <br />SUBJECT TO WQUX�9 COAMENSATEOM LAWS OF CALIFORNIA-' COMTRACTOR•S NIKIMQ IMI SURCONTRACTIHD SIGNATURE CERTiFIES THE FOLLOJING: <br />CERTIFY THAT IN THE PERFORMANCE OF THE WOR& FUR MNTCM THIS PERMIT IS I59UED, [ SMALL EMPLOY PERSONS SUBJECT TO ToRKER•s <br />CHI <br />LCMPEI6ATId! Ut14 OF CALIF <br />APPLICANT'S SIGNATURE: TITLE Contractor DATE 10-11-95 <br />Bry�Ruschhau t Presidepill of Calif. Petroleum Equipment Inc. <br />,"olv Tr the reePvgTote PRSaf h <br />arty to Waft Ia ler adaftTonBt PMI -END staff t+NN: expanded beyond the 0 h, m9n9otel Lotion Payrrnt. <br />The Arty Rst acbaled <br />uge this responsibility for the additiunaL billing by Si9Marure and oJac beloa. <br />Ra N_ __ _ California Petroleum Equipment Inc <br />taping kute PO Box 9364 Fresno Ca. 93792 <br />Bay Phone Surber <br />10-11-95 <br />FH 23 0011 caw 11Tl92) WP <br />