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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson, Pros. Gty of Lodi <br /> Patricia E. Vannuccl, Secy. San Joaquin County <br /> *nlhonette Van Spronsen 1801 Eaat Hazelton Avenue, P. O. Box 2008 City of Eaulon <br /> -arl Plmentel Stockton, Callfornla 95201 City of Manteca <br /> Fern Bupbee 209/488-8781 City of Ripon <br /> Daniel L. Flores Gty of Stockton <br /> John D. Mast, M.D. City of Tracy <br /> William J. Wade Joel Khanna, M-.0- M,P,%... ,•ke2r4--: V,r If O Im San Joaquin County <br /> Mary Anna Love San Joequln County <br /> UNDERGROUND STORAGE TANK PROGRAM <br /> RE: PERMANENT CLOSURE TANK REMOVAL POLICY* <br /> The following information shall be submitted in duplicate on all Permanent Closure/ <br /> Tank Removal Plans: <br /> 1 . Facility address and telephone number of owner (or operator if different than <br /> owner). <br /> 2. Provide a parcel plot plan showing tank(s) to be removed and tank(s) distance <br /> from all premise septic tanks, buildings, and property lines, and all wells <br /> within 500 ft. <br /> 3. Provide the name of the contractor, including contractor's classification, <br /> license number, and certificate of workers' compensation insurance. <br /> 4. Identify the tank(s) size and product(s) currently and/or previously stored in <br /> each tank. <br /> ' 5. Provide the name of laboratory that will collect soil samples and a "Release of <br /> Information Authorization" form signed by the facility owner/operator. <br /> 6. Identify the method of disposal of all residual liquid, solids or sludges, <br /> if applicable. <br /> 7. Identify how the tanks will be purged of all flammable vapors to preclude <br /> explosion or to levels specified by existing regulations. <br /> 8. Method of disposal or reuse: <br /> a. If the underground storage tank or any part of an underground storage tank <br /> is destined for a specific reuse, identify the future underground storage <br /> tank owner/operator, location of use, and nature of use. <br /> b. If an underground storage tank or any part of an underground storage tank <br /> is destined for reuse as scrap material , identify this reuse to the <br /> San Joaquin .Local Health District. <br /> c. If the underground storage tank or any part of the underground storage tank <br /> is to be disposed of. identify and document the method of disposal . <br /> On submission of the above information the closure plan will be approved, approved with <br /> changes, or disapproved. <br /> After approval of plan, contact with this office is required to schedule an inspection <br /> at least 24 hours prior to tank removal/soil sampling. <br /> * The above general policy shall apply to underground storage tanks which have no <br /> known unauthorized release or other unusual circumstances. All other closures <br /> may require additional site specific activities prior to approval of the closure <br /> plan. <br /> 3/86 UGT 10 <br />