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ENVIRONMENiAL 11FALiN DIVISION <br />APPLICATION TOR UNDERGROUND STORAGE TANK CLOSURE PERMIT <br />APPI.ICAIIntl FOR PfR11ANENT/11E.IIPORARY CLOSURE nR ARANDONMFNT IN PLACE OF uNnERGRnI1ND NATARDOUS SUBSTANCE STORAGE TANK <br />11119 PER111T EMPIRES 90 DAYS FROM 111E APPROVAL DATE. DO Not WRITE IN ANY SHADED AREAS. INDICATE PERMIT TYPE BELOWI <br />X REMOVAL TEMPORARY CLOSURE _ CLOSURE IN PLACE <br />EN 23 046 (Revised 4/26/94) Pege 3 <br />EPA SI IF. 0 CA8210020832 <br />j PROJECt CONTACT R tfLEPNONE 0 Sharon Dean ( 209) 982--2427 <br />t <br />A <br />►Ar, tl. l r Y NAME DDRW- Sharpe Facility PHONE N (20,9)982-2427 <br />-- <br />AnnaEs <br />700 E. Roth Rd. Lathrop, CA <br />1s <br />L <br />r.Rnss IMEr Air Port Way <br />t <br />ou►rfaiorfanroa Same as above <br />HONE III <br />PHONE(209)982-2427 <br />( 209) 982-2427 <br />Y <br />c <br />crnrranr.roR NAMF JIM THORPE OIL, INC. <br />PNO"F 1200368-6175 <br />N <br />1 <br />rolflRActnR Annafss 351 N. Beckman Rd., Lodi, CA 95240 <br />CA LIC 0495699 <br />CLASSA B Haz <br />a <br />A <br />_— <br />t►►suar:R Landmark & Genstar <br />1095135o.. <br />C <br />t <br />— <br />IIRF. nrsrarr• <br />- _ .. __..�harpe Facility <br />PERMIT 0 <br />Upon -approval of plan <br />0 <br />R <br />I.ARnRA1nRY NAME GeoAnalytical Laboratories <br />PNoNE �' (209)572-0900 <br />-- - — <br />-- <br />GeoAnal tical Laboratories PItoNE N <br />SANi'IINO ►IPM (20q 19 <br />IIIIIIIIIII1111111�11111111111 2_QqQQ <br />IANK 10 TANK SIZE CIIEMICALS STORED CURRENTLY/PREVIOUSLY DATE UST INSTALLED <br />37 550 gallons Waste 01.1 Uk <br />A <br />11l97771l•--•1l�--_1l- <br />lillllIllllIIIiIIilltttitllililt <br />I1AP1P1R1IO1IV1 <br />11111'11_111A11PP1R1O11VE1D11W1I1II1TI1llI1 11Dl1lIilS1Ai1Pt1Pl1Rl1Oi1Vl <br />Vil, <br />_V,E11D11 <br />_ <br />1 <br />IIIl3137-- <br />7li�li <br />A S ACIIMENT WITH CONDITIONS) <br />N PIAN PEvIFNPPS NAfrF <br />E11 DATE <br />1l_1_l1l-1i1l1_l <br />1l�_1l <br />1ElD <br />1l1l1l1l1l1l1l1l <br />Jill ICIOIIIlIIDlIlIIlTIlI1Oi1Nl1l(1lS1l) 1l1i1l1l1l1.i_1l1.l_1i�11l <br />IIIJIJ,ilQ1111111 1111, 11 <br />APPI.1CA11t ilUST PERFORM ALL WORK IN ArCORDANCE WI1N SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS OF <br />SAN JOAn1J1il CUUNIY PI1NlIC IIEALiN SERVICES. MIER OR LICENSED AGENT'S SIGNATURE CERTIFIES 111E FOLLOWING! "1 CERTIFY MAT IN <br />111E PERFOR11A11r.F or t1IF- VoIlK FOR WIIICII 11113 PERfi1t 1S ISSUED, i SIIALL NOT EMPLOY ANY PERSON IN SUCH A MANNER AS 'TO RECOME <br />SURJECt 10 W WR'S COTIPFNSAtI(IN LAWS OF CAI.I►ORNIA." CONTRACTOR'S MIRING OR SURCONtRAC1INd SIGNA/URE CERTIFIES iNE FOLL(VINAI <br />"I CFRiI►Y It1At 10 111E PER►ORf1ANCE OF THE WORK FOR WIT THIS PERMIT 15 ISSUED, 1 SHALL EMPLOY PERSONS SUBJECT TO WORKERIS <br />rrlfIPENSAlluN LAWS of CALIFORNI <br />APPLICANI'S SIGNAIUREI tlttE Contractor DAtE7/5/95 <br />EN 23 046 (Revised 4/26/94) Pege 3 <br />