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9255517888 Line 1 :35 p.m <br />12-16-2008 5/13 <br />E a III IF oft <br />1 1 <br />S lel J A COUNTY <br />304 East Weber Avenue, Third Floor, Stockton, California 95202 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 <br />��(( THIS PERMIT EXPIRES 90 DAYS FROM THE APPROVAL DATE. INDICATE PERMIT TYPE BELOW: <br />LrJTANK RETROFIT ❑PIPING REPAIPiRETROFrr ❑UDC REPAIR/RETROFIT <br />F <br />EPA Site # CAL000225719 Project Contact & Telephone # Liddy McKenzie (925.551.7555) <br />A <br />C <br />Facility Name ARCO 2130 Phone # 209.957.2987 <br />I <br />L <br />Address 7906 EL DORADO ST, STOCKTON, CA 95210 <br />1 <br />T <br />Cross street PLYMOUTH RD <br />Y <br />Owner/Operator BP West Coast Products LLC Phone # <br />C <br />0 <br />Contractor Name Gettler-Ryan Inc Phone # (925) 551-7555 <br />T <br />Contractor Address 6747 SIERRA CT, SUITE J, DUBLIN, CA94568 <br />CA Lic # 220793 Class ".C1o.Cs?.Cstmaer AZ"C <br />R <br />Insurer STATE COMPENSATION INS FUND <br />Work Comp# 238-0003058 <br />C <br />T <br />ICC Technician's Certification Number 5259192 -UT <br />Expiration Date 05/18/2009 <br />R <br />ICC installer's Certification Number 5259192 -UI <br />Expiration Date 12/20/2009 <br />Tank ID # Tank Size Chemicals Stored Date UST Installed <br />Currently/Previously <br />T <br />A <br />N <br />K <br />P <br />❑Approved AApproved with conditions ❑Disapproved <br />L <br />See Attachment With Conditions) <br />A <br />N <br />Plan Reviewers Name Date e10 <br />APPLICANT MUST PERFORM ALL WQR<OIPN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS OF SAN <br />JOAQUIN COUNTY, ENVIRONMENTAL HEALTH DEPARTMENT. OWNER OR LICENSED AGENTS SIGNATURE CERTIFIES THE FOLLOWING: "I CERTIFY THAT IN <br />THE PERFORMANCE OF THE WORK FOR ICH THI PERMIT IS ISSUED, 1 SHALL NOT EMPLOY ANY PERSON IN SUCH A MANNER AS TO BECOME SUBJECT TO <br />WORKER'S COMPENSATION LAWS OF IFOR CONTRACTOR'S HIRING OR SUBCONTRACTING SIGNATURE CERTIFIES THE FOLLOWING: "I CERTIFY <br />THAT IN THE PERFORMANCE OF THE ORK F WHICH THIS PERMIT IS ISSUED, I SHALL EMPLOY PERSONS SUBJECTT OR R'S COMPENSATION LAWS <br />OF CALIFORNIA." t <br />Applicants signature Tkie AGENT FUR OWNER Date 09/1 2008 <br />%--- BILLING INFORMATION: <br />Indicate the responsible/party to be billed for additional EHD staff time expended beyond permit payment coverage per tank. if <br />the party designated below is different than the permit applicant, e.g. property owner, the party must acknowledge this <br />responsibility for the billing by signature and date below. <br />NAME Liddy McKenzie mLE Project Manager PHONE # 925.551.7555 <br />EH230038 (revised 818/06) !� ®/1��✓/ <br />1 <br />