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_ :t :tttit{ ttAtitt:tttti•t;tt-tttttttt•tt.tZ•it:tttttttt.It,t2r `VtLiv v <br /> t. APPLICA`, PERMIT t: SAN JOAQUIN LOCAL HEALTH <br /> t: UNDER6ROU ANK t: 1601 E HAIELTON AVE., SfOCr.TON FV <br /> t: CLOSURE OR ABANDONMENT t; Telephone (209) 468-3426O <br /> t <br /> n:►x►s':�::::::`:::�s:��?:N:»»:_x�xN: �x��: n:►v:::::::::uOle.►s:►.xNO). <br /> - - ... .. . .. NOV 9 d 1989 <br /> AMICATIOM FOR PERMAMENTITEMPORARY CLOSURE OR ABANDONMENT IN PLACE OF UNDERGROUND HAIARDOUS SUBSTANCES STORAGE FACILITY <br /> IS rERM1T EXPIRES 90 DAYS FROM THE APPROVAL DATE. DO NOT WRITE IN ANY SHAD!➢ AREAS. INDICATE PTTj�YM��TAL HEALTH <br /> Y__ REMOVAL TEMPORARI CLOSURE AbANDONMENT IN PLACE �'�RMITT/SIEERVICES <br /> EPA SITE I CAC 000223089 PROJECT CONTACT I� TELEPHONE I Je�,P94a,-9 <br /> rgin_.� 107 <br /> F FACILITY NAME Largin's Service PHONE I (209) 946-9107 ?- <br /> C ADDRESS 2235 Cherokee Road, Stockton, CA 95205 <br /> L CROSS STREET Myron Avenue <br /> T OWER/OPERATOR Largin' s Service PHONE 1 (209) 946-9107 <br /> Y ► <br /> C CONTRACTOR NAME .�.PNONE <br /> Jim Thorpe Oil , Inc. l� (209) 462-4581 <br /> N CONTRACTOR ADDRESS 351 N. Beckman Road, Lodi, CA CA LIC 1 495699 JCLAS-S A, Haz <br /> T <br /> R INSURER on file WORK.COMP.t on file <br /> A <br /> C FIRE DISTRICT City of Stockton . PERMIT VINSPTR <br /> 0 LABORATORY NAME McLaren Environmental Engineering PHONE 1 (916) 638-3696 <br /> SAMPLING FIRM! same SAMPLING METHOD Brass tube - see #5 on removal plan <br /> TANK 16 1 TANK SIZE/ CHEMICALS STORED CURRENTLY CHEMICALS STORED PREVIOUSL <br /> T _ 10,000 U empty -5 years leaded gasoline <br /> A 39_ """af-"------- 10,000 empty 5-years leade gasoline <br /> -- ---------------------- <br /> ----------------------------- <br /> LIST ADDITIONAL TANK INFORNATION AS NEEDED ON SEPARATE FORM <br /> APPROVED APPROVED WITH CONDITIONS DISAPPROVED <br /> E ATTACHNEN WITH CONDITIONS) <br /> A REVIEWERS NAMEDATE I o� <br /> N - --------------------- ---.... <br /> �-J- --/--------- <br /> APPLICANT NUST PERFORM ALL WORK IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINAHC-S, STATE LAWS, AND RULES AND REGULATIONS <br /> OF THE SAN JOAQUIN LOCAL HEALTH DISTRICT. OWNER OR LICENSED AGENT'S SIGNATURE CERTIFIES THE FOLLOWING: 11 CERT!F" THAT <br /> IN TIE PERFORIIAa OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON IN SUCH MANNER AS TO BECOMI <br /> Siq,IECT TO WORKER'S COMPENSATION LAYS OF CALIFORNIA. CONTRACTOR'S HIRING OR SUBCONTRACTING SIGNATURE CERTIFIES THE <br /> FOLLOYIM6: 11 CERTIFY THAT IN THE PERFORMANCE 7 THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL EMPLOY PERSONS SUBJEC <br /> 10 WONIfQ'S COMPENSATIa LAYS OF CALIFORNIA. <br /> CALL FOR INSPECTIONS AT LEAST 48 HOURS IN ADVANCE <br /> tMllEa Vice-President DATE 11/77/89 - - _- <br /> --- - ----- .- - - ------------------- --------- ------ -• - - <br /> IFFICE 1 E t)'--Elf 23 0;6 1218! J <br /> NiiKffifffitfffffftffftfff4ftffffffffffffifffsfffffiii/tfffftiffifftfflffffitfftflfffffffftfffifffffffittiffftfftiftitft <br />- COMP 1LOC CODE DISI CODE AMOUNT DUE AMOUNT RCVD CKNCA5H RCVD BY DATE RCVD PERMIT 1 <br />