Laserfiche WebLink
rAYMENT <br /> RECEIVED <br /> N 0 Y 13 1992 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH DIVISION <br /> APPLICATION FOR UNDERGROUND STORAGE TANK CLOSURE PERMIT <br /> APPLICATION FOR PERMANENT/TEMPORARY CLOSURE OR ABANDONMENT IN PLACE OF UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANK <br /> THIS PERMIT EXPIRES 90 DAYS FRCM THE APPROVAL DATE. DO NOT WRITE IN ANY SHADED AREAS. INDICATE PERMIT TYPE BELOW: <br /> X REMOVAL _ TEMPORARY CLOSURE _ CLOSURE IN PLACE <br /> EPA SITE N CAD809137126 PROJECT CONTACT t TELEPHONE Tom Juano (209) 956-4751 <br /> F FACILITY NAME Stockton Steel PNO)IE f <br /> A (209 956-4751 <br /> C ADDRESS 3003 E. Hammer Lane Stockton, CA <br /> L CROSS STREET Holman Road <br /> I <br /> T OWNER/OPERATOR PHONE ! <br /> Y Herrick Tom Juano <br /> 209 956-4751 <br /> C CONTRACTOR NAME DECON Environmental Services, Inc. PHONE 0 <br /> 0 (510) 732-6444 <br /> N CONTRACTOR ADDRESS 23490 Connecticut Street CA LIC ! 545726 CLASS A <br /> T <br /> R INSURER State Compensation Insurance Fund WORK-00RP•4 <br /> A 430-92 Unit 26 <br /> c FIRE DISTRICT Stockton Fire Department I PERMIT N <br /> T <br /> 0 LABORATORY NAME Sequoia PHONE T <br /> R (415) 364-9600 <br /> SAMPLING FIRM H 0 Geol Gary Lowe PHONE N (510) 373-9211 <br /> IIIIIIIIIIIIIIIIIII1�111111111 <br /> T NK ID 0 TANK SIZE CHEMICALS STORED CURRENTLY/PREVIOUSLY DATE UST INSTALLED <br /> 39- 10,000 niaaal A rox. March <br /> T 39- R.ono T)i ocnl 79-• <br /> A 39- 9.ono ni coral �ARn <br /> N 39- NA 1(1.(1(1(1 11n1 aarlaA (:ac TCIOn. �. <br /> K 39- <br /> 39- <br /> 39- <br /> P IIII �1111TfI1T <br /> L _ APPROVED APPROVED WITH CONDITION(S) _ DISAPPROVED <br /> A TT CKNENT WITH CONDITIONS) <br /> N PLAN REVIEWERS NAME DATE — <br /> IIIIIIIiillillllllll IIIiI <br /> APPLICANT MUST PERFORM ALL WORK IN ACCORDANCE WITH 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 FOLLOWING: a1 CERTIFY THAT IN <br /> THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, L SHALL NOT EMPLOY ANY PERSON IN SUCH A MANNER AS TO BECOME <br /> SUBJECT TO WORKER'S COMPENSATION LAWS OF CALIFORNIA.- CONTRACTOR'S HIRING OR SUBCONTRACTING SIGNATURE CERTIFIES THE FOLLOWING: <br /> 9 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL EMPLOY PERSONS SUBJECT TO WORKER'S <br /> COMPENSATION LAWS OF CALIFORNIA.- \\ �p <br /> APPLICANT'S S[GNATURt.`�nA7 J7 /�J TITLE SyrqGr V/.COQ DATE /o-9Z <br /> ' EH 23 046 (Revised 7/10/92) Page 3 <br />