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BOARD Of YItUSYEESo <br /> Culbart'�on, Prat.aT h City of Lodi <br /> S QUIN LOCAL HEALTH DISTRICT SERVING <br /> la E. Vannuccl, soc'y, ` San Joaquin Count <br /> Anthoneflo Van Spronaan p��t sst Hazelton Avenue, P. �. f30X 2009 City of Eacalon <br /> Eat Plmental G Stockton, California 95201 Ci <br /> Daniel <br /> ManlaCa <br /> Fern eugbee 119 <br /> Daniel f.. Flora• 209/468-8781 City orRipon <br /> a <br /> John D. Meat, M.o. City of Stockton <br /> Mary <br /> lam n Wad• � ����.n - Coy or runty <br /> Jogt Khanna, M.D.. M.P.H., Dlatrkt Health of 11Y�1 o City County <br /> Mary Anna Low oaQuln County <br /> Y UNDERGROUND STORAGE TANK PROGRAM JAN 2 0 1,987 <br /> RE: PERMANENT CLOSURE' TANK REMOVAL POLICY* ENVIROMENTAL HEALTH <br /> PERMIT/SERVICES <br /> The following information shall be submitted in duplicate on all Permanent Closure/ <br /> Tank Removal Plans: ' <br /> 1 . Facility address and telephone number of owner (or operator if different than <br /> owner). <br /> 2. Provide a parcel plot plan showing tank(s) to be removed and tank(s) distance <br /> from all premise septic tanks, buildings, and property lines, and all wells <br /> within 500 ft. <br /> 3. Provide the name of the contractor, including contractor's classification, <br /> license number, and certificate of workers' compensation insurance. <br /> • 4. Identify the tank(s) size and products) currently and/or previously stored in <br /> each tank. <br /> 5. Provide the name of laboratory that will collect soil samples and a "Release of <br /> Information Authorization"- form signed by the facility owner/operator. <br /> b. Identify the method of disposal of all residual liquid. solids or sludges , <br /> if applicable. <br /> 7. Identify how the tanks will be purged of all flammable vapors to preclude <br /> explosion or to levels specified by existing regulations. <br /> 8. Method of disposal or reuSe': <br /> a. tf the underground storage tank or any part of an underground storage tank <br /> is destined for a specific reuse, identify the future underground storage <br /> tank owner/operator, location of use. and nature of use. <br /> b. If an underground storage tank or any part of an underground storage tank <br /> is destined for reuse as scrap material . identify this reuse to the <br /> San Joaquin Local Health District. <br /> c. If the underground storage tank or any part of the underground storage tank <br /> is to be disposed of, identify and document the method of disposal . <br /> On submission of the above information the closure plan will be approved, approved with <br /> changes.. or disapproved. <br />- ter approval of plan, contact with this office is required to schedule an inspection <br /> at least 24 hours prior to tank removal/soil sampling. <br /> * The above,general policy shall apply to underground storage tanks which have no <br /> known uf{authorized release or other unusual circumstances. All other closures <br /> may require additional site specific activities prior to approval of the closure <br /> plan. <br /> 3/86 UGT 10 <br />