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0 , EHD G -C cony <br /> e;-:�pt <br /> Rk HEAR SERWES <br /> 'a I SAN JOAQUIN COUNTY <br /> JOGI KHANNA M.D.,M.P.H. <br /> Health Officer <br /> N. P <br /> P.O. Box 2009 . (1601 East Hazelton Avenue) " Stockton, California 95201 ,t�Foar� <br /> vCY1M�`�� UNDI DEPARTMENT OF TRANSPORTATION <br /> rGl� 5 mfnTrRlnls <br /> FEDERAL AVIATION ADMINISTRATION <br /> WESTERN-PACIFIC REGION <br /> GENERAL <br /> o, WILLIAM COPELAN Ilicant with comments. <br /> 1. Submit all Foreman <br /> Environmental Compliance <br /> 2. Include a c �(rh bistank location and type, piping, <br /> streets and (213)297-1191 I f(I AIr aY Facilities Division-AWP-464.5 cion of the nearby septic tanks, <br /> FTS: 984-119 15000 Aviation Blvd. water,sanitary sewer and storm <br /> sewer), <br /> an- ��e !�V' I 8 -I© HamhOme. CA 90206 <br /> s <br /> 3. Complete page 3, "Application for Underground Tank Closure Permit". <br /> I/ 4. Complete page 9, "Authorization to Release Analytical Data". <br /> IL{/ 5. Submit the appropriate fees and complete page 11,the"Underground Tank Program Fee Worksheet". <br /> It}/ 6. Describe on pages 4& 5 the decontamination techniques if applicable,material(s) utilized for rinsate, <br /> transportation and/or storage of hazardous waste generated on site, and specify the responsible <br /> party(ies) who will be disposing of waste generated on site. <br /> M 7. Describe on page 5 the method for purging and/or inerting tank(s) and piping. <br /> 3. Describe on page 5 in detail how soil and/or water samples beneath the tank(s) and piping will be <br /> obtained. Su�4Ic,,iL + 7 <br /> 9. Complete the pertinent section of page 10,the Public Health Services-Environmental Health Division <br /> (PHS-EHD) "Underground Tank Disposition Tracking Record". The holder of the permit shall be <br /> responsible for ensuring that this form is completed and returned to PHS-EHD. <br /> 10. Submit a "Site Health & Safety Plan", as an addendum to this application, to address all potential <br /> hazards for this specific job site. Refer to Site Safety Plan Guidance Document for specifics. <br /> H. Submit a "Compaction Report" as required by the County of San Joaquin Building Department and <br /> it's incorporated City Building Departments, pursuant to the Uniform Building Code STD 70-1. <br /> 12. Obtain a "Grading and Excavation Permit" from the City of Tracy Building Division prior to PHS- <br /> EHD approval of the closure plan. <br /> 13. The maximum review time for Closure Plans is 15 working days from receipt of the adequately <br /> completed plan. If gross deficiencies are identified, an addendum will be required with a $53.00/hour <br /> fee and the review will begin on the date of resubmittal. <br /> 14. Submit verification of the fire permit from the appropriate fire district (prior to scheduling removal <br /> inspection). <br /> 15. Advance inspection notice of at least 48 hours is required by Public Health Services. <br /> Page I <br /> A Dirkiun of San Joaquin County Ilolth Cate Services <br />