Laserfiche WebLink
ENVIRONMENTAL HEALTH DIVISION <br /> APPLICATION FOR UNDERGROUND TANK INSTALLATION PERMIT <br /> APPLICATION FOR INSTALLATION OF UNDERGROUND TANKS ARE ONLY VALID FOR THE CALENDAR YEAR IN WHICH IT HAS BEEN ISSUED. <br /> A PERMIT NAY BE EXTENDED INTO THE NEXT CALENDAR YEAR IF A LETTER IS SENT TO PHS-EHD REQUESTING THIS EXTENSION THIRTY DAYS <br /> PRIOR TO THE END OF THE CALENDAR YEAR. A ONE YEAR -- ONE TIME EXTENSION KAY BE GRANTED BY PNS-END UPON RECEIPT OF THIS LETTER. <br /> DO NOT MITE IN ANY SHADED AREAS. <br /> EPA SITE S FIRST APPLIED 1/10/92 PROJECT CONTACT L TELEPHONE 6 <br /> FACILITY HAMS ORCHARD SUPPLY HARDWARE DISTRIBUTION CENTER PHC"E 0 209-833-3100 <br /> ADDRESS 2650 N MAC ARTHUR DRIVE, TRACY, CA <br /> CROSS STREET GRANT LINE ROAD <br /> GONER/OPERATOR PHONE 9 <br /> ORCHARD SUPPLY HARDWARE 408-281-3500 <br /> CONTRACTOR MAKE W L HICKEY SONS INC PHONE 9 408-736-4933 qcl <br /> CONTRACTOR ADDRESS1904 COMMERCIAL ST, SUNNYVALE CA LIC =095122 CLASS C-36,C-4,C-20,C- 2,C-16 <br /> HAZARDOUS WASTE CERTIFIED YES_ MO% woRK.caa.s WC0604726-00 <br /> FIRE DISTRICT TRACY PERMIT 0 <br /> BOARD OF EQUALIZATION C SRGH98-035099 <br /> I 11111111�11111�11111111111111 <br /> TANK ID ✓< TANK SIZE CHEMICALS TO BE STORED PROPOSED INSTALLATION <br /> 39- DATE <br /> 39- <br /> 39- <br /> 39- <br /> 39- <br /> 39- <br /> 39- <br /> APPROVED APPROVED WITH CONDITION(S) _ DISAPPROVED <br /> (SEE ATTACHMENT WITH CONDITIONS) <br /> PLAN REVIEWERS NAME DATE <br /> 11111111111111111111 11111 <br /> APPLICANT MUST PERFORIN ALL WORK IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAYS, AND RULES AND REGULATIONS OF <br /> SAN JOAOUIN COUNTY PUBLIC HEALTH SERVICES. OWNER OR LICENSED AGENT'S SIGNATURE CERTIFIES THE FOLLOWING: •1 CERTIFY THAT IN <br /> THE PERFORMANCE OF THE YORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON IN SUCH A MANNER AS TO BECOME <br /> SUBJECT TO YORKER'S COMPENSATION LAWS OF CALIFORNIA.- CONTRACTOR'S HIRING OR SUBCONTRACTING SIGNATURE CERTIFIES THE FOLLOWING: <br /> °1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL EMPLOY PERSONS SUBJECT TO WORKER'S <br /> COMPENSATION LAYS OF CALIFORNIA.- <br /> APPLICANT'S SIGNATURE: TITLE CONSTRUCTION MGR DATE 5/1/92 <br /> .1 23 000 (Rev 1/7/92) WP Page 3 <br /> 3 <br />