Laserfiche WebLink
ENVIRONMENTAL HEALTH DIVISION <br /> APPLICATION FOR UNDERGROUND STORAGE TANK CLOSURE PERMIT <br /> APPLICATION FOR PERMANENI/IENPORARI CLOSURE OR ABANDONMENT IN PIACE OF UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANK <br /> THIS PERMIT EXPIRES 90 OATS FROM THE APPROVAL DATE. DO NOT NRIIE IN ANY SHADED AREAS. INDICATE PERMIT TYPE BELONI <br /> X REMOVAL TEMPORARY CLOSURE _ CLOSURE IN PLACE <br /> EPA SITE P CAC001004008PROJECT CONTACT R IEIEPHUNE E Patrick Riddle (209)952-6262 <br /> F FACILITY NAME Ramsey Real Estate Develooment / Filbert Prop.ert PHONE 0 (209)466-5733 <br /> A <br /> C ADDRESS 740 N. Filbert St. Stockton, CA -9444&gsaor <br /> 1 <br /> I CROSS STREET Fremont St. <br /> 1 <br /> I OWNER/OPERAIOH PRWE IF ( <br /> Y Same as above 209)466-8733 <br /> [ CONTRACTOR NAMEJ1III Thorpe 011, Inc. PHONE / (20 462-4581 <br /> 0 <br /> N CONTRACTOR ADDRESS351 N Beckman Rd. P.O.RX. 357 EtIC 4 �6 CLASSum <br /> T a e1 mP. ns. ui d <br /> R INSURER Fll•esmans Fund/ Pacific Insur. Co. , LTD uoRK.cOMP.I 15. <br /> A <br /> C FIRE DISTRICT City of Stockton PERMIT E011 approval of plane <br /> 1 <br /> 0 IABORAIORY NAME GeoAnalytical Laboratories PHONE B (209)572-0900 <br /> R <br /> SAMPI IMG F INH Same as above PHONE B (209)572-0900 <br /> — III111111111111111�11111111111 <br /> TANK ID TANK SILE CHEMICALS STORED CURRENTLY/PREVIOUSLY DATE UST INSTALLED <br /> 550 gallons leaded gasoline unknown <br /> 1 39- <br /> A 39- <br /> N 39- <br /> K 39- <br /> 39- <br /> — IIiinnrrnnnnnnnnnn nrrnnrrnnmm�nnnnm nnnnnnmm�nnmrrtnnnnrr nmrmm�mm�r <br /> P <br /> L APPROVED APPROVED WITH CONDITION($) DISAPPROVED <br /> A (SEE ATTACHME I WITS CONDITIONS) <br /> H PIAN REVIFUEAS MANE L DATE - �L- / T <br /> — nlnluuunnuunn�ir frnn m'r I nnnnnrnnrnrrrnmmnnrrmnulnrrrnrnnnnnnrrnnnn <br /> APPt(CANT MIST PERFORM ALL NARK IN ACCORDANCE UIIH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS OF <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES. OWNER OR LICENSED AGENT'S SIGNATURE CERTIFIES THE FOLLWINOI "1 CERTIFY THAI IN <br /> THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, 1 SHALL NOT EMPLOY ANY PERSON IN SUCH A MANNER AS TO BECOME <br /> SUBJECT 10 WORKER'S COMPENSATION LAWS Of CALIFORNIA." CWTRACIOR'S HIRING OR SUBCONIRACTING SIGNATURE CERTIFIES THE FOIIWING: <br /> "1 CERTIFY THAI IN THE PERFORMANCE OF INE WORK F R-WHICH NIS PERMIT IS ISSUED, 1 SHALL EMPLOY PERSONS SUBJECT 10 WORKER'S <br /> f OF CLORNICOMPENSATION IAW <br /> APPLICANTS SIGN <br /> 't-Gt TILE Contrac6or <br /> DATE <br /> EH 23 046 (RevlSed 2/10/92) Page 3 <br />