Laserfiche WebLink
NOV 13 1992 <br /> ENVIRONMENTAL <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 FROM 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 0 CADS09137126 PROJECT CONTACT i TELEPHONE 0 Tom Juano (209) 956-4751 <br /> F FACILITY NAME Stockton Steel PHONE t <br /> (209 <br /> A 956-4751 <br /> C ADDRESS 3003 E. Hammer Lane Stockton, CA <br /> I <br /> L CROSS STREET Holman Road - <br /> I <br /> T OWNER/OPERATOR PHONE 0 <br /> Y Herrick Tom Juano 209 956-4751 <br /> C CONTRACTOR NAME DECON Environmental Services, Inc. PHONE 0 <br /> O (510) 732-6444 <br /> N CONTRACTOR ADDRESS 23490 Connecticut Street CA LIG 0 545726 CLASS A <br /> T <br /> R INSURER State Compensation Insurance Fund WORK.CONP.0 430-92 Unit 26 <br /> A <br /> C FIRE DISTRICT Stockton Fire Department PERMIT 0 <br /> T <br /> 0 LABORATORY NAME SegUOl.a PHONE 0 (415) 364-9600 <br /> R <br /> SAMPLING FIRM H O Geol Gary Lowe PHONE 0 (510) 373-9211 <br /> 11111111111111111111 X111111111 <br /> T NK ID 0 TANK SIZE CHEMICALS STOREDCURRENTLY/PREVIOUSLY DATE UST INSTALLED <br /> 39- 10,000 niPspl Approx. March <br /> T 39- A.nnn nipepl <br /> A 39- nnn ni papl <br /> N 39- 1(1.nnn - _L1n 1 PadPd Clan IqRN <br /> K 39- <br /> 39- <br /> 39- <br /> P IIII I1111TffrrrffiT ffm <br /> L _ APPROVED APPROVED WITH CONDITIONS) _ DISAPPROVED <br /> A 4-E ATTACHMENT WITH CONDITIONS) <br /> N PLAN REVIEWERS NAME DATE <br /> 11111111111111111111 11111 <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: at CERTIFY THAT IN <br /> THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I 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 /> "I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, 1 SHALL EMPLOY PERSONS SUBJECT TO WORKER'S <br /> COMPENSATION LAWS OF CALIFORNIA.* n / <br /> APPLICANT'S SIGNATURE-�� O�l/alLt�Si�J.� TITLE SyrG��.�;pp <br /> V/SdQ GATE '//0-92 <br /> EH 23 046 (Revised 7/10/92) Page 3 <br />