Laserfiche WebLink
.� SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ` ENVIRONMENTAL HEALTH DIVISION <br /> APPLICATION FOR UNDERGROUND STORAGE TANK CLOSURE PERMIT <br /> ' THE PERMIT FOR PERMANEVT/TEMPORARY CLOSURE OR ABANDONMENT IN PLACE OF UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANK <br /> EXPIRES 90 DAYS FROM THE APPROVAL DATE DO NOT WRITE IN ANY SHADED AREAS INDICATE PERMIT TYPE BELOW <br /> ' XX REMOVAL TEMPORARY CLOSURE CLOSURE IN PLACE - <br /> EPA SITE # 981375157 CXj ', `-� Pa CT CONTACT 8 TELEPHONE # Gar Haeck PhD R.G 916-364 0793 <br /> F FACILITY NAME Newark Sierra Paperboard Mill PHONE # 209-466-7088 <br /> A <br /> C ADDRESS 800 West Church Street, Stockton CA 95203 <br /> I <br /> L CROSS STREET Stockton Street <br /> 1 <br /> T OWNER/OPERATOR PHONE # <br /> Y 209-466-7088 <br /> C CONTRACTOR NAME OGISO Environmental PHONE # 510-451-5771 <br /> 0 <br /> N CONTRACTOR ADDRESS 1504 Franklin St St 304 CA LIC # 706242 CLASS A-HAZ <br /> R INSURER Oakland, CA 94612 ! WORK COMP.# <br /> 1341233 <br /> ' A <br /> C FIRE DISTRICT City of Stockton - Fire Prevention Division PERMIT #98_96 <br /> T <br /> 0 LABORATORY NAME Chromalab Inc COLIN Ty A 1 amed a I PHONE #510-484-1919 <br /> ' R _ <br /> SAMPLING FIRM Hardirilawson Associate$ � �r �� ,� PHONE # 916-364-0793 <br /> 1I11l1lI1f111lI111111!!!�!Il11 <br /> Tr D It TANK SIZE CHEMICALS STORED CURRE4TLY/PREVIOUSLY DATE UST INSTALLED <br /> 39- /() 210 ,000 9-allons Residual fuel diesel #6 <br /> 39- <br /> 39- <br /> N 39- <br /> K 39- <br /> 39- <br /> 39- <br /> P Illlllllif111111l11l11lllIII11 1111 fill 11111111111 r 11!!1liill 11l1i1111lfllllfill111111111i111f1l1ili !f!Illfllilllfllilll! <br /> L APPROVED _ APPROVED WITH CONDITION(S) DISAPPROVED <br /> A (SEE CONDITIONS BELOW AND/OR ON ATTACHMENT) <br /> PLAN REVIEWER'S NAME f ? 1+ � �` DATE <br /> i <br /> 1111111111111111l1i1I!111Il1Illlllllll11111[IIl11111l1l11f1lIl11!l111111!1II1i111i1l1Il1I11l1111I11fl1IlI1l1i1111111l11111111 <br /> APPLICANT MUST PERFORM ALL WORK IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS OF <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES OWNER OR LICENSED AGENT'S SIGNATURE CERTIFIES THE FOLLOWING "I CERTIFY THAT IN <br /> THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON IN SUCH A MANNER AS TO BECOME <br /> SUBJECT TO WORKER'S COMPENSATION LAWS OF CALIFORNIA " CONTRACTOR'S HIRING OR SUBCONTRACTING SIGNATURE CERTIFIES THE FOLLOWING <br /> '11 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL EMPLOY PERSONS SUBJECT TO WORKER'S <br /> COMPENSATION LAWS OF CALIFORNIA <br /> APPLICANT'S SIGNATURE TITLE ji i P FAY (, 20/04 S/oaTE q-Z Ile <br /> J <br /> 1y <br /> ONDMO�(S> f• S e�— G l'�L�-,a-` !�`- - y 1 S� `l Ll <br /> Z r T� �l.A.I+t--- V"-t v.JV1'�l C�-y�7�r'L.t� �"�li'1 Li.N`i��1..1�\ � G✓� �{"�- 1.� <br /> 4' G v� cit <br /> _�j ��ti.c�-�F�_� ,3 ti.�j��--off..` 0. Ce.J'�3�� ✓�"'� ,'��-Lr-/,l �_V�°�( � l (wv� <br /> Ca <br /> -P,,,r��c�C�r7?' r��r �-,.._� C--� •�z�C 1�+,J�:�.ir+li � r r J� ��f <br /> EH 23 046 (Revised 9/11/96) jj (Rag 3 l C <br />