REMOVAL REMOVAL 1989 - Laserfiche WebLink

Home Browse Search

tt fi ,1111 t t tt U 0 t t tt ttH1Wt Yggsav4bAPPLICA� FOR PERMII �: SAN JOAOUIN LOCAL HEALTH ICTUNDERGkOUND TANK X, 1601 E HAIELION AVE., STOCKTON CAt C. CLOSURE OR ABANDONMENT e: Telephone (209) 460-3420 Y: AUG 21 1989 APPLICATION FOR PERMANENT/TEMPORARY CLOSURE OR ABANDONMENT IN PLACE OF UNDERGROUND HAZARDOUS SUBSTkN0R9)9*i£NfTkTiP9,)kLTH THIS PERMIT EXPIRES 90 DAYS FROM THE APPROVAL DATE. DO NIT WRITE IN ANY SHADED AREAS. INDICATE PERM IRERrAT✓dF*YICES X REMOVAL TEMPORARY CLOSURE ABANDONMENT IN PLACE O C CONTRACTOR NAME Jim Thorpe Oil, Inc. 0 -- --- - — -- --- —. N CONTRACTOR ADDRESS 351 N. Beckman Road, Lodi, CA PHONE 1 (209) 462-4581 CA LI -Cl.- 495699 CLASS A, Haz. _ T—. —. --i --- R INSURER on file WORK. COMP A on file C FIRE DISTRICT San Joaquin County PERMIT I/INSPTR T -- — 0 LABORATORY NAME Canonie Environmental— PHONE 1 (209) 983-1340 SAMPLING FIRM# same TANK ID I TANK SITE T A 39--a35 10,000 0_ --- 500 ---per -- ----- SAMPLING METHOD brass tube -see #5 on removal CHEMICALS STORED CURRENTL CHEMICALS STORED PREVIGUSL None leaded qasoline LIST ADDITIONAL TANK INFORMATION AS NEEDED ON SEPARATE FOPM APPROVED APPROVED WITH CONDITIONS DISAPPROVED L P T/ - (SEE �A j�CHMENT WITH CONDITIONS) J �/ A PLAN REVIEWERS NAME __ DATE �_[_[__ � . . N / APPLICANT MUST PERFORM ALL WORK IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS OF THE SAN JOAQUIN LOCAL HEALTH DISTRICT. OWNER OR LICENSEDAUNT'S SIGNATURE CERTIFIES THE FOLLOWING: 'I CERTIFY TAAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 1S ISSUED, l SHALL NOT EMPLOY ANY PERSON IN SUCH MANNER AS TO BECOM SUBJECT TO WORKER'S COMPENSATION LAWS OF CALIFORNIA.' CONTRACTOR'S HIRING OR SUBCONTRACTING SIGNATURE CERTIFIES THE FOLLOWING: 'I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, 1 SHALL EMPLOY PERSONS SUBJEC TO WORKER'S COMPENSATION LAWS OF CALIFORNIA, CALL FOR INSPS*fiiOJOS AT SIGNED ----------------- OFFICE SSE ONLY --EN 23 sssslususssstssssssss I,JLOCICODE JOISTCODE, AMOUNT DUE 48 HOURS IN ADVANCE a ------V DATE 8/18/89 ftfffffitfitflt4ifffitttittittititftftif •I RCVD-1Y I DbTE KCVO - I PERMIT 1 M EPA SITE 1 CAC 000148565 PROJECT CONTACT L TELEPHONE 1 (209) 943-1981 F FACILITY NAME Valley Auto Repair PHONE 1 (209) 462-1808 C ADDRESS 4055 N. Wilson Way, Stockton, CA L CROSS STREET Newton Road - --- —._— —__— 1 T OWNER/OPERATOR — Stanley S. Moore PHONE 1 209) 943-1981 O C CONTRACTOR NAME Jim Thorpe Oil, Inc. 0 -- --- - — -- --- —. N CONTRACTOR ADDRESS 351 N. Beckman Road, Lodi, CA PHONE 1 (209) 462-4581 CA LI -Cl.- 495699 CLASS A, Haz. _ T—. —. --i --- R INSURER on file WORK. COMP A on file C FIRE DISTRICT San Joaquin County PERMIT I/INSPTR T -- — 0 LABORATORY NAME Canonie Environmental— PHONE 1 (209) 983-1340 SAMPLING FIRM# same TANK ID I TANK SITE T A 39--a35 10,000 0_ --- 500 ---per -- ----- SAMPLING METHOD brass tube -see #5 on removal CHEMICALS STORED CURRENTL CHEMICALS STORED PREVIGUSL None leaded qasoline LIST ADDITIONAL TANK INFORMATION AS NEEDED ON SEPARATE FOPM APPROVED APPROVED WITH CONDITIONS DISAPPROVED L P T/ - (SEE �A j�CHMENT WITH CONDITIONS) J �/ A PLAN REVIEWERS NAME __ DATE �_[_[__ � . . N / APPLICANT MUST PERFORM ALL WORK IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS OF THE SAN JOAQUIN LOCAL HEALTH DISTRICT. OWNER OR LICENSEDAUNT'S SIGNATURE CERTIFIES THE FOLLOWING: 'I CERTIFY TAAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 1S ISSUED, l SHALL NOT EMPLOY ANY PERSON IN SUCH MANNER AS TO BECOM SUBJECT TO WORKER'S COMPENSATION LAWS OF CALIFORNIA.' CONTRACTOR'S HIRING OR SUBCONTRACTING SIGNATURE CERTIFIES THE FOLLOWING: 'I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, 1 SHALL EMPLOY PERSONS SUBJEC TO WORKER'S COMPENSATION LAWS OF CALIFORNIA, CALL FOR INSPS*fiiOJOS AT SIGNED ----------------- OFFICE SSE ONLY --EN 23 sssslususssstssssssss I,JLOCICODE JOISTCODE, AMOUNT DUE 48 HOURS IN ADVANCE a ------V DATE 8/18/89 ftfffffitfitflt4ifffitttittittititftftif •I RCVD-1Y I DbTE KCVO - I PERMIT 1 M