Laserfiche WebLink
APPLICATION FOR PERMIT k: SAN JOIpUIN LOCAL HEALTH DISTRICTk: �) <br /> t; UNDERGROUND TANI t: 1601 8 AIZ86TON AVB., STOCKTON CAT: �'` 'Y <br /> g CLOSURB OR ABANDONMENT t: Telephone (209) 468-3420 t: '' tp <br /> tti'ti1111 i tt ti ti'ti kii tt ti ti ti tt ki l'i tttYki ki'tYL'i ti li ti till:ti kill:ti: A�' <br /> IPPLICATION FOR PBRMANBNT/TBMPORIRT CLOSURE OR ABANDONMENT IN PLACE OF UNDERGROUND HIIIRDOUS S 088 "ORAGE TY <br /> THIS PERMIT EXPIRES 90 DAYS PROM THE APPROVAL DITB. DO NOT WRITS IN llT SIIADIO AREAS. INDICATE TT T BBLO <br /> XX REMOVAL _ TEMPORARY CLOSURE _ ABANDONMENT 19 PLACE �i�y <br /> EPA SITS I C000193991� PROJECT CONTACT A TELEPHONE I- - <br /> F FACILITY MAKE RAINBO BAKERY PdodE 1 _ <br /> A — — <br /> C ADDRESS 108 EAST WALNUT STREET, LODI CA 95204 <br /> 1 — — <br /> L CROSS STRICT ALLEN DRIVE <br /> I -- <br /> t OWNER/OPBHItOH CAMPBELL TAGGART, INC. PEONS 1 618/281-7173 HANK BELLINA <br /> T <br /> C CONTRACTOR NINE MCON PHONE 1-916/372-7535-- - <br /> 0 <br /> N CONTRACTOR ADDRESS P.O. BOX 1024 W. SACTO CA 95691 CA LIC 1 510034 CLASS "A" <br /> R INSURER STATE FUND VORK.00MP.1 570-88-2318 <br /> C FIRE DISTRICT LODI FIRE PERMIT I/INSPTR <br /> T -- - -- <br /> 0 LABORATORY NINE I .T. LABORATORIES PHONE 1 213/921-9831 <br /> R <br /> SAMPLING FIRM$ I.T. LARORATORIES SANFLING NEtdoo 5030, 8020, TEL & EDB <br /> -- IUIWCWtlIUUIIIWWIIIIYNRWVHIIIIIIYMAWIHIIUIIUIIVI;UIIIWIVYiNUtltllWl ------ ---•— <br /> TANI ID I TAII SITE CHEMICALS STORED CURRENTLI CHENICILS STORED PRBVIOUSL <br /> T % - � 1 000 GASOLINE911 — <br /> A 39 -- -' - 0 — -- — a <br /> 139 — TANK WILL BE DISPOS D OF AS SCRAP_- TRIANGLE CONSTRUCTION <br /> 19 _------_-- - SACRAMENTO <br /> 39 -- -- - <br /> --------------- <br /> -- LIST ADDITIONAL TANK INFORMATION AS NEEDED OR SEPARATE FORM <br /> IIIIYVMUIIIINNYVUNIIIIIYYIW!IIIUIIIIIUVWItlRU;IHIIIWBIlY1111V1NIlYIW�I1B BBIdIIIUIIIIIlid1UWIIIIIIIIIIIIIIIWIOU!iHWIIIV!Yi!flIUJ11191YlUlUkUUWYVkW!UIUUWiIUIIIIIIIU'JVY`IWYiIUft'JY!WiIYIIIUUBUJ!119UIIIoIBIIUUIiNWVIiUUIIIIBWVUANUIUVIlA41BIYGINIJIIUVUBIUIWVYIWUI"i� <br /> P _ APPROVED _ APPROVED WITH CONDITIONS _— DISAPPROVED <br /> L c j /' - ^ �,�38H ATTACHNEKT WITH CORD CYS) <br /> A PLAN REE NAME —_ x r `-----__ _—_—_—DATR—d-zl------ <br /> Y <br /> UWYYWIItlINYIMRWWI�IIWIWNtlYYMIIIYW{AWYNUYWYVWUYWVBWNRNYIYYYWUIVYIWWWYYUYMWIUIIWWIUIWWYIUWVV➢I�IMIII INIIWWIUVIBIYWWIBIWMIWWYIYNWWWtlI!GkWUYIUNAWYUdWWWWVY@WIIIWIWWWIIIPWtlMWIBVWMdIWYIWYVY <br /> APPLICANT MUST PERFORM ALL WORK IM ACCORDANCE WITH SAN JOIQUIN COUNTY ORDINANCES, S11TE LAYS, AND RULES IND REGULITIONS <br /> OF THE SAN JOAOUIN LOCAL HEALTH DISTRICT. OWNER OR LICENSED AGENT'S SIGNITURB CERTIFIES THE FOLLOWING: 11 CERTIFY THAT <br /> IM THE PERFORMANCE OF THE YORK FOR WOICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON IN SUCH MANNER AS TO BECON <br /> SUBJECT TO YORKER'S COMPENSATION LAYS OF CILIFORNIA.' CONTRACTOR'S HIRING OR SUBCONTRACTING SIGNATURE CERTIFIES TH8 <br /> FOLLOWING: '1 CERTIFY THAT IN THE PERFORMANC¢ OF 111E YORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL EMPLOY PERSONS SUOJEC <br /> TO YORKER'S COMPENSATION LAVS OF CALIFORNIA. <br /> CELL FOR INSPECTIONS AT LEAST 90 HOURS IN ADVANCE <br /> SIGNED_ <br /> - -- ------------------- ---------- <br /> OFFICE USE ONLY--811 21 016 12111 <br /> SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSISSSS <br /> SWEEPS I-I-COMP I•• ( hoe-CODE I-DIST COOS, AMOUNT OUR I ANOUMI RCVD I CKI/CASA-�-RCVD BY -I- DATE RCVD —( PERMIT 1 - <br />