Laserfiche WebLink
SAN J O A Q U I N Environmental Health Department <br /> COUNTY <br /> 7 . See ' Sampling Protocol for Routine Tank Removals ' and 'Verification Analysis ' on page <br /> 6 and 7 of the permit application for required analytical tests and number of samples to <br /> be taken and witnessed by EHD . <br /> 8 . A copy of the Fire Department permit must be submitted at the time of removal . <br /> 9 . In addition , the following information must be submitted within 30 days after the UST <br /> removal date ; <br /> a . Analytical results : only results that come directly from a third party California <br /> certified laboratory with affixed chain of custody will be accepted by EHD <br /> b . UST Tracking Record Sheet and/or Tank and Piping Hazardous Waste Manifest <br /> c . Tank Closure Certification Form ( DTSC Form 1249 ) <br /> d . Hazardous Waste Manifest for rinsate and residual product <br /> e . Backfill Excavation Certificate <br /> 10 . Permit expires 180 days from the date of approval . If an extension to the expiration <br /> date is required , a written request must be submitted to this office prior to the expiration <br /> date . <br /> If you have any further questions , please contact me at (209 ) 468- 0216 . <br /> Thayou , <br /> AShet Woldearegay , EHS <br /> Environmental Health Specialist <br /> cc: Pilot Travel Center LLC- Joey Cupp, 5508 Lonas Rd, Knoxville <br /> joey. cupp@pilottracelcenters. com <br /> 2 of 2 <br />