Laserfiche WebLink
PUBLIC HEALTH SERVICES <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DIVISIONUX ` <br />Karen Furst, M.D., M.P.H., Health Officer%�P <br />304 East Weber Avenue, Third Floor • Stockton, CA 95202 <br />209/468-3420 <br />PERMIT APPLICATION <br />TO INTERIOR LINE/REPAIR UNDERGROUND STORAGE TANKS <br />NOTE: ONLY UNDERGROUND STORAGE TANKS CONTAINING MOTOR VEHICLE FUEL MAY BE REPAIRED BY THE <br />INTERIOR LINING PROCESS. IN ACCORDANCE WITH SECTION 25296 OF THE CALIFORNIA HEALTH AND SAFETY CODE, SUCH AN <br />UNDERGROUND STORAGE TANK MAY ONLY BE REPAIRED ONCE. <br />Site EPA # <br />Tank ID #-tc lL <br />Facility Name: A2c.o 4, tl3a— <br />Facility <br />Address: V. � <br />City: S�ack� <br />Stat : co, Zip Code:. t5� <br />Contractor Name: S Cod Cow.e,,w� <br />Contractor Address (mailing): U \1 <br />10r City: <br />4� State: CO, Zip Code: <br />c6kS �} <br />Lining <br />Contractor Address: aa- SObNS U:x, <br />�� City: <br />(5 <br />.�.�� Nl r���. State: 0*b6 Zip Code: C� DI,S� <br />❑ Approved ❑ <br />Disapproved <br />/ <br />MA proved with the followin conditions: <br />C&'a <br />(lipks < ° <br />L 1 an <br />I <br />o -ti ,amu . <br />Date 3 -!(7—f,9 . H. S. ,a <br />� <br />f <br />A Division of San Joaquin County Health Care Services <br />