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JIM THORPE OIL , INC. <br /> 351. N. Beckman Road <br /> P. 0. Box 357 <br /> Lodi , California 95241-0357 <br /> (209) 368-0109 or 462-4581 <br /> December 23, 1986 (tn <br /> San Joaquin Local Health District ISLE 3 V O <br /> 1601 E. Hazelton Avenue <br /> P. 0. Box 2009 DEC 24 1986 <br /> ! <br /> Stockton, CA 95201 ENVIROMENTAL HEgE-rH <br /> Re: Permanent Closure/Tank Removal Plans PERMIT/SERVICES <br /> 1 . Owner/Operator: Lodi Funeral Hone Phone 369-3564 <br /> Facility address: 725 S. Fairmont, Lodi , CA 95240 <br /> 2. Parcel plot plan showing tank(s) to be removed attached. <br /> 3. Contractor Name: JIM THORPE OIL, INC. <br /> Contractor Classification: A <br /> Contractor License Number: 495699 <br /> Certificate of workers' compensation insurance on file in your office. <br /> 4. Tank # on plot plan Tank Size Products currently or previously stored <br /> #147 350 Unleaded Gasoline <br /> 5. Laboratory that will collect soil samples Canonie Engineers <br /> A signed "Release of Information Authorization" is attached. <br /> 6. Method of disposal of all residual liquid, solids , or sludges , if applicable: <br /> Tank clean of sludges, liquid and solids <br /> 7. The tanks will be purged of all flammable vapors to preclude explosion or to <br /> levels specified by existing regulations by incarting dry ira at IS lhc_ <br /> per 1 ,000 gallons <br /> 8. Method of disposal or reuse: tank will be transported to Triangle, Inc. _ <br /> 52nd Street Sacramento, CA for disposal <br />