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APPLICA1160 FOk PERni,► <br /> ' A SAN MAKIN LOCAL HEALIN MINI.] � Cori,+_�. <br /> I UMOER6NQUND TANI: A IGT+f E iIAlELiOn AVE., j1UC1;7Uji CA A <br /> A CLOSURE Gi; ALAnDr]Nn[NT irl7pi►4sc (dG9J 4{,$-'��;'U ` <br /> a <br /> NpADALAbLe5MbAgot AA_n I :i.rru,'^A laGa�s!GHu,:d1:NAGsrkllpa:Ac4y�7 bL1AD <br /> APPLICATION f0R PEtMAnFNT/TE?IPry8AR1 CLUSUF.E OR ARANDONMEPI! 1N PLACE Or Uh!) ikllUtiD HA1Aa;D0Cij 5ULS7AN:ES S1;]kr<�t ft;;LiTY <br /> THIS PERMIT ErPlP,ES 90 DAYSfROn THE APPVUV,�L UTE, DAG kOT WR'TE IN ANY ShAUED AREAS, IkD1CATE PERMIT TYPE SEM4: <br /> 1 <br /> X ! <br /> -• REMOYAL •-_- TEnr"UkARY CLOSURE APANDONMEai IN PLATE <br /> e,.Y 1 I 1 <br /> 4e, <br /> I r j <br /> EPA Ulf i I <br /> CAL 000OU3403 PFGIECT CONTACT i iELEPHOHE I <br /> - — - _�-- -- ------ 7:1� 6 3 4-LP,(L <br /> F FACILITY NAME "Fast Gas" _ - +ONE r ( 2 09 369-3124 ` - <br /> C ADDRESS <br /> 1 800 E. Highway <br /> CkD55 STREET Lower Sacramento Road`- ------- �- - -- -- - - -- <br /> OkNERlOPEkATOR gonna Tompkins PHONE I <br /> ( 209 ) 369-3124 <br /> LID <br /> INSURER + - <br /> - I L � I�I N <br /> F 1 kE D[S iR fORK.COMP,i � <br /> �-n m _ _ <br /> --- � — ------_ ._ :_...— NSP--_ ---_:.-,�_�_ 0�_ 'I��___=_---f 2 I�-�•.y� ,' <br /> !CI J'EIiJ{li i/-1Tk <br /> LABORATORY NAME <br /> i <br /> sAMPLIN F1Rn1 SAhPLIW3 MEI-HOD -- <br /> + <br /> TANID i TAW', Sl1C <br /> :3TGr CUP�LNJLY I.hERICAIS <br /> 10 , 000 Gal. Reg. Gasoline <br /> -- - 01 --- ----.... TXTGa� - Su <br /> _ --- Pnl: Gasoin"-___�.-._._ <br /> ---- �4�0�'�GaT.` _ - — __ --- - <br /> --�q- - --�-L---- -' - -- — u_n_1 Gasoline ( - <br /> -------------- - --- ----- <br /> LiST ADDITIDNA', TAHr.' iN ORMATION AS hEEGED ON SEPARAIE FORn <br /> APFi;CtVED AFFk2Vt0 41 1H CONDI fIONS __- DISAFPkOVEO 1, <br /> PLAN REViEWEkS Nanf <br /> (SEE ATIALh!tEHT N1I8 CONDIIJONS) <br /> / <br /> MM RriVG{fr •1i.Yf.L��:f�fe i lfa /{41WY ' N y <br /> [CANT MUS] PIVORM ALL WORK IN ACCORDAN E HIiH SAN JOAMN CUUNTY GF'D:NA;It;ES, SIIJE LAWS, ArrD RU_E=, AND PFGu!-A11GNS <br /> HE SAN JOAOUIN LOCAL HEALTH N SiklC1. OWNE►? CR LICEH;EO ALCkT'S 51SNAlut:E CEF,T1fIES IFIL rL'LLiulk+;; •( �,'ER'i1FY )MA) <br /> ME PERFCknaN;E 0i THE Wllk}; FOR NH1r,H TM1S PERcMIT IS 1SSUE0, I Sr1ALL W EAPL OY AkV PtkSDN IN Slt;rl KAr,hCl A; )i) <br />'ECT i0 WORKEP'S C0MPLti,AiION IAwj of CALIFOPNIA.' CChil+a:iGR+; 01 'IF" OR SUBCONTRA.TIh;: SIGNANi;E CERitil.; 1Nf <br /> uulJi.;: '1 CEVIFr THAT IN THE PEYFORMAN!, OF THC 1+0k; FUP WkICN THiS fEP,MIi ISSUED, I SHALL EMFLCY FCf,unS L'iI,!l;1 <br /> ORI.ER,'S CQMPf"A"" WS OF CALIFORNIA. <br /> CALL 0 SPS T ONS AT LEAST 48 HOURS IN ADVANCE <br /> I+ <br />++$stil%%l;ssttt it ills%$$$Illit$llisylsiitl:itis!s%slli1,illiiliiii$islSsiisli;ii4li}!iiiillliiltsit$SySilill;liis �' <br /> 1 � SOrF ! QLD+. .0D( !DIST CCD;' AhCUlii DUE' , AhUUIIT PLQ r;1'1ICA5!t kl.%o e� nett rrun <br />