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EE:C 21 '98 17.55 F -E T _ GI riEERING' A P • 4 P.07 <br />chat - C! <br />SAN JOAOEnN COUNrY MBLIC HFALTH SERVICES <br />ENVIRONMENTAL HEALTH DEMION <br />ApMcAnON FOR UNDERGROUND STORAGE TCLOS PER -WT <br />14E PERaM1 T FOR PEWANENT/TEMPCRART CLOSURE OR MIWOWNT IN A gE OF UNDEACROU90 MAZAROOUS SU$STANci STORAcEE TAMC <br />aXPIRiS 90 LAYS FROM THE APPROVAL. OATS. 00 NOT URITE IN A*Y $4460 AREAS, %NOICATS PERMIT TYPE ff .cu. <br />X Rf}gvAC �„ T@kpGRAAT CL4SUR( CLOSURE tN PL„AC¢ <br />EPA WE i Cl r, 0 2 ra t <br />$ACILITY NAME ',i f4 "►Srr, f4. <br />PRaiw CONTACT L TELE # 44 'J2i ytiL,,a�e. f -70 7 a <br />trj ± 4 PWOK P 1-L'? -"ASI - <br />e aODRESs tool F.- 4 0 uw4+ irk 4 <br />t <br />L CROSS 01e1T �, a <br />t <br />T tYasNER�OPERATtle i a s <br />N-G�.w♦!`3�eA br'L'iw +K� ,(J% `fi✓!i+'��� w� <br />oE coNr4rwcTOR Herbst ETA i•^eef'in In . aHON[ r r316) 381-72 7 <br />a j CONTaAC.®R A00RESS P.O. Srsx 294067 CA LIC 9 SC3266 CLASS AJHAZ <br />4 F <br />R INSUMIt State YiearkEsr i 6OK-C •9 12161CS-87 <br />A `33 <br />i C f1R¢ CIS=RIOT 4.„„ ' >ERMiT <br />, <br />o AL�gARAtpRY MANL cj kA' CTAIM>T SAGr }-sr PNQME s �lta� 3. �yQ'ejlf 7r <br />sA®nvLsac FaaM s 3uCi� >�®}fir G•r Sw+ t4Z.� 7 PHONE a< �{fI? 3ts��. S� <br />I!{{t{!{[[!{!1K#Pols TANK $119 PNEdtICALS t CURRE�L` OPqEVtcusLT I D> Md LMLED <br />A 39 • ,,� �,R2�.' Rte, ..,.,...®... _ .� -._.. ®.,_.. tom» lin . <br />N 34- <br />R 59- <br />34 <br />L APPROVED; APP WITH MON(S) OI4APPR�VEG <br />j cowlTC RdLON AN*jO* ON ATTACHNENTi r I <br />"a <br />i N ALAAI A£vtEL1ER'S NAME r4. ~ GATE <br />IIlilt [tt{tt{lift{!!!t{ltltttt!!!I!!llttitZiaill{iitllttt t{!!!It!!t!4!;!t!t{{!ltltil!{Pitltt!{{{f!1!!!{{It{!If!!{1{!I!{! <br />APPLICANT MUST PERFORM ALL WOW CM ACf,0OAM(j WITH SAN JOAa11TM C(AMTV jIROINANCES, STATE LAj4, AMG AutfS AMD RECULATtONS OF <br />i SAa aGADLiIR COUNTY PUBLIC ttEAlih S>ZRv#CES. 4MNER GR L10Ei1SEO 7°4 SIG"TUR£ CERTLFtES r* FOLLCN/MG: at ,ERTify TIFAT IH <br />Tref PERfuemAMCE Of III WQAK SCR w lCa Tv(3 11 tS ISSUED, I SHALL MOT t;1PLOY AMY PC Son 4M S' A MANNER AS 'A COME <br />SUSJECT To 41196RIS *UTION LAWS OF wALIFGs2HWA CONTRACTQE'S AfAINO OR SUBG@NTRAMMa SIRMATURI CitIMES Tri€ FOLLOWIAC: <br />•,I CERTIFY YHAT IN THE PERFOR$VXCE Of INC "t FCR t-WICN THIS PERMIT tS 'S21ED, t SHALL CChfta1' PgAums SUBJECT r0 rORKER'S <br />(,OlIPEh3iJ.TtR1s �AarS OF CALdf41IN1A,w <br />Aam:,cANT s SILNAvuRer <br />d....�- <br />TITLE QWt& A DALE � 4 <br />EM 23 044 CRwtayd 9/41/961 sloe 3 <br />