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t lt!t$t!'t ' t1,tt tttt t tt tt LY tt tt Litt tt tt a att'atvtt tt-0't' lmt-tv <br /> k: APPL]w FOR PERMIT k: SIN JOIQUIN LOCAL NEALTtIICY k: <br /> t` UYDIRGROUND TANK k 1601 B HAYELTOM AVB., ST T01 CAk: <br /> k: CLOSURE OR IIIHOONMINT k: Telephone (209) 668-7620 t' <br /> t'tt'!t�kt�kYlt'!t'tt'!t'tC'l'tt'N't tt'tY�tt'tL'�kk�tt�t'1�tt t4'tt'tt'tt'kt�tt�kl'�l1�t2�li'tt�N'kS <br /> IPPLICITION ?01 PIRMANRNT/TIMPOIIIY CLOSUPI OR ABANDONMENT IN PLACE OF UNDERGROUND NISIIDOUS SUBSTINCRS ST02AGI FICILITY <br /> THIS PERMIT EXPIRES 90 DIYS FROM THE IPPROVAL DIT8. DO NOT TRITE IM 111 SIIADIB ARE1S. INDICITI P1RMI1 TYPE BELOW! <br /> X REMOVAL _ TEMPORARY CLOSURE ABANDONMENT IN PLICI <br /> EPA SITEPIOJICT CONTICI I TELEPHONE I JIM HOBLITZELL 463 7108 <br /> I <br /> -- CALOM8379 _. ......._-....._......._._.....- - ----- ---- --- ---- <br /> F FACILITY NAM/TRI-STATE MOTOR TRANSIT PHoxe 1 (209) 835 8800 (JOB SITE) <br /> C IDDRESS 25501 PATTERSON PASS ROAD, TRACY, CALIFORNIA 95376 <br /> 1 — <br /> L CROSS STREET PATTERSON PASS ROAD & STATE INTERSTATE 580 <br /> ? OWNER/OPBRITOR PHONE <br /> T TRI-STATE MOTOR TRANSIT (209) 835 8800 <br /> C CONTIICTOR NIM[ FALCON ENERGY PHONE 1 (209) 463 7108 _ <br /> 0 ----- -- --- <br /> 1 Calf"CIOR ►DDRISSBOx 30356, STOCKTON, CA 95213 CI LIC 1581{524 CLISS A <br /> I INSURER ON FILE VOILCOMP,I ON FILE <br /> C FIRE DISTRICT TRACY PERMIT I/1NSPTR <br /> 0 LIBORITOIT NIM' BC LABS. BAKERSFIELD, CA PNON[ I (209) 838 3507 <br /> — 1 -- — <br /> SAMPLING FIRM' SIMPLING METHOD <br /> IwMUN�utlNWntlelYAmtWIIYtl� I I ESCALON, CA _ SEE ATTACHED SAMPLING PROTOCOL <br /> TANK 10 1 TANK SIIE CHIMICILS STORED CURREIfL1 CHIMICILS STORED PIIVIOUSL <br /> ? 10,000 NONE DIESEL <br /> WNL----- �TE�EI _----- <br /> NONE DIESEL___,,. <br /> Jf ----— --- _ — 004—--.---- -- E-- GAS01 T <br /> - LIST IDDITIONIL TANK INFOIMITION IS NEEDED OY 9EPARITB POEN <br /> WmkNNWIWtlIYtltlIIVIHYIWIIIWWURBUUUUNWWYWIUIIUWUYYIrI RIWIItlItltlIIIWWIVWIUYUIIIIIIIINIIIWIIMIIDUIIIIIIUIIIUIIWHIIIIIIIYUIYUYVIINptlIImUYWNtlYUUltltltltlAltIWNNWMYUYtlNtlIWMYUUItltlIIWYtltlImUrIIlpHtltllNtlpWWMNIWIIIYWWUHIMNUNWYWIu <br /> P APPROVED APPROVED WITH CONDITIONS DISAPPROVED <br /> L (SER ATTACHMENT WITH CONDITIONS) <br /> 1 PLIN REVIEWERS MINE DITe <br /> N -- -------------------------------- ------------------- <br /> NYN�WYWtltlRRWNrJ19YlRNIN1INEIINIIYIYWIWWNUVUYMYtltltlWOYtlYNWIWBUWVWYINDYWYYWIUNYWXYWHWYWWWIWIINIWIYYtNYWIIWNNWWdYYWWYWNYNWWtlWWWYYWUYWVAWYVWIYXYWrWYVY1MUWINYIBKtlWWIN1U <br /> IPPLICANT NUN PERFORM ILL VOHI IM ACCORDANCE WITH SIN JOIQUIN COUNTY ORDININCES, STITE LIPS, AND RULES IBD REGULITIONS <br /> OF THE SIN JOAOUIN LOCAL HEALTH DISTRICT. OWNER OR LICENSED IGENT'9 SIGNITURB CEIIIFIE9 THE FOLLOWING: 11 CWRIIFY ?HIT <br /> IY THE PERFORMANCE OF THE 101% FOR WHICH THIS PERMIT 13 ISSUED, I SHALL NOT EMPLOY ANY PERSON IN SUCH MIWNER AS TO BECON <br /> SUBJECT TO YORKER'S COMPRISItION LIPS OF CALI?ORXIA.' CONTRACTO119 HIRING OR SUBCONTRACTING SIGBITURB CERTIFIES THE <br /> FOLLOVIIG: 11 CritI1Y ?HIT IN THE PERFORMANCE OF ?HI TOP[ FOR WHICH THIS PERMIT IS ISSUED, I SHALL EMPLOY PEISONS SUBJEC <br /> TO VORKII'S COMPEISI?ION LIWS OF CALIFORWII. <br /> CALL FOR INSPECT ONS T LEAST 48 HOURS IN ADVANCE <br /> SIGNED= `_ --------- - -----DIf[ J�?L��i 1-=--- <br /> OFFiCf USffl— <br /> S9SSSb 9S9S99349S9SSS 99953 SSSSS999SSSSS S9S9S9SSSSS9S9SSSSSSSSSSSSSSSSSSS9SSSSSSS939SSSSSS9SS9S99S919SSSS9!!SSSS <br /> SWEEPS-I-�--Cox P-I-- LOC-I'll <br /> -IVDIST----f -IMAUNT DUB.!- AMOVNF -RCVD--I --'CXUCASR _IBT DITB 1CVDIPERMIT IJ � J. <br />