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State of Calltornia--Health and Welfare Agency J Department of Health Services <br /> Toxic Substances Control Division <br /> APPLICATION FOR VEHICLE/CONTAINER INSPECTION <br /> Page of <br /> Phone 1209) 462-5082 <br /> Firm Name STOCKTON CONTRACTING GROUP, INC. Contact Person Jerry Joy <br /> Inspection Address <br /> Mailing Address 1000 N. Union StreW!"t Sto&�yon Calif. ZIP 95205 <br /> P.O.Box/Street - City ZIP <br /> EPA ID No. Hauler Registration No. <br /> AMPLE: <br /> 87 Fruehauf 1AA2345 Tank Trailer <br /> 84 Consolidated Ser. No. 1234 Roll-off Box <br /> FEES CHP USE ONLY <br /> Veb$7 Yr. License Plate or Certif irate Certification <br /> Con639 Mfr Make Container No. Body Type Number Date S ecifitation <br /> 1 --qbw— 73 Inter 1P 77 222 10 Wheel Dump <br /> 2. 87 GMC 3E 38 754 3/4 Ton Pick-Up <br /> 4. <br /> 5 .. <br /> 6. <br /> 7. <br /> 8. . . <br /> 9. <br /> ' t0. <br /> 11. <br /> 12. <br /> 13. <br /> ] 15. <br /> 17j 16. <br /> 17. <br /> 18. <br /> 19. <br /> 20. <br /> $ TOTAL FEES FOR THIS PAGE <br /> APPLICANT CERTIFICATION <br /> 1 certify under Penalty of perjury that to the best of 7mknowledge and belief the vehicles)and container(s)described above conform to the repuiromants of <br /> Title 22,California Coda of Regulations. <br /> Jerry Joy Vice President 92/03/89 <br /> T ar Printed Nama 1 Position <br /> CH US� ONLY <br /> RECOMMENDATION: 11Approval 13Denia (New) ❑ HS Action(ReneWal) REMARKS: <br /> TERMINAL: ❑ Satisfactory 11Unsat factory ❑ Not Evaluated <br /> Signature IDNumber Division Date <br /> SEE INSTRUCTIONS ON REVERSE <br /> DHS 8025 (4/88) <br />