Laserfiche WebLink
r• APPLICITIOY FOR PERMIT SIN JOIQUIN LOCAL HEILTH DISt11CTk: <br /> t UNDERGROUND TANI t: 1601 I HIZUTON IVB., STOCKTON Clt: <br /> t: CLOSURR OR IIINDONMENT t Telephone (109) 161-1120 t! <br /> t'ty1:111:ti:ti tt tl:tvti tit tl:tl:tl:tl:tt7 1:11t:1:111:ti:ft ti ti:ti ff tt tt tt:tt tl:tt:tl: <br /> IPPLICITION FOR PERMANEWI/TEMPORIRT CLOSUII OR 1BANDONMENT IN PLICI OF UNDERGROUND H111RDOUS SUBSTINCE$ STORICE FICILITY <br /> THIS PERMIT RIPIRNS 90 DAYS FROM HE 1PPROVIL DATE. DO NOT 111178 IN 111 SIIADII AREAS. INDICITE PERMIT TYPE 19LOW: <br /> RHNOVAL TEMPORARY CLOSURE 1811DONMRNf IN PLICI <br /> EPI SIT[ I 5`� Ossl PROJECT CONIICT 1 TELEPHONE`I <br /> r` / r3'os� - 9>-6sss <br /> F FICILITY MIME PHONE I <br /> 1 - ��X92 97- / <br /> C 1DDRISS <br /> L CROSS STREIT <br /> 1 <br /> T OWNER/OPERITOR PRONE I <br /> C CONTRICTOR NINE PRONE 1 — — <br /> o <br /> 1 CONTRICTOR ADDRESS 60�/ �`� �I2�, �- <br /> T / Ci LIC I �7S D/ CLISS <br /> R INSURER YORK.COMP.I <br /> C FIRE DISTRICT PERMIT I/INSPTR - <br /> 1 <br /> 0 LIBORITOIT N1M8 y aU l'� '`"''1 �u <br /> PHONE I <br /> R <br /> SIMPLl1C PIRM� SIMPLINC METYOD <br /> — N6CLWIWtlWWUW�tlWN � � _ <br /> TINT ID I iIKI SIZE CHEMICILS STORED CURRENTL CHEMICILS STORED PRNVIOUSL <br /> T <br /> /D DDD <br /> r <br /> 39-� �L4—KI <br /> Ali <br /> ]9- <br /> LIST IDOITIONAL TANK INFORMITION IS NEEDED ON SEPARITB FORK <br /> �uuuul�uwuur.�I+WuwlulwWuuu�wunWuuuuauuwDu�lwWu�wl 1�uuuuwlv�laWWluuu�Iluc:wWlW�u�uW�uwwuwuuuW>�uruwuw,wtau,cuuuruu�u>m�uir�uuwu�w�wuvw�uwutWuaur�uumwuwu.uuWllWu�u�uWw,uWua�umw�Wu1,��, <br /> P APPROVED MIPPROVID WITH CONDITIONS DISAPPROVED <br /> (SAI 1TTICUMI Y WITH CONDITIONS) <br /> 1 PLAN REVIEWERS N1NB � BITE � CQ <br /> RRINNYRI W IIYO`WltlletlYlIN11PN�W1,e!en e�W! :k!uk'uuei�w �� noun ury in ni tlW.r"W{IWIIWWWIWlRRIlwIecWLu�unueitWRWIItlIR1RL'KIIYGNWRIYWYNtlY1JyyL"NIW(W <br /> 1PPLICINT MUST PERFORM ILL TORI IN ICCORDINMCYYE WITH SAN JOIQUIM COUNTY ORDININCES, STATE LAYS, AND RULES IND RECULITIONS <br /> OF THE $11 JDAQUIN LOCAL HEALTH DISTRICT, OVNER OR LICENSED AGENT'S SICNITURR CERTIFIES THE FOLLOVINC: 11 CERTIFY THAT <br /> 11 THE PERFORMANCI OF THE YORK FOR WHICH THIS PERMIT IS ISSUED, I SHILL NOT EMPLOY ANY PERSON )N SUCH MINNER 1S TO BECON <br /> SUBJECT TO YORKER'S COMPENSITIOM L/YS OF CALIFORNIA,' CONTRACTOR'S HIRING OR SUBCONTRACTING SIGNITU29 CERTIFIES THE <br /> FOLLOWING: 11 CERTIFY THAT IN THE PERFORMIMCE OF Till WORT FOR VVICH THIS PERMIT IS ISSUED, I SHALL EMPLOY PERSONS SUBJRC <br /> TO VORIIR'S COMPENSITION LIPS OF CILIFORNII. <br /> CALL FOR=INSPECTON�SA LrAST 40FLOURS IN ADVANCE <br /> OFFICI USt NLY•-tll I) f4i 12/11 --' DlTB__ <br /> SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS:SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS <br /> SVIEPS I I COMP I ILOC CODE ( DIST COOL 1MOUNT DURI AMOUNT RCVD I CXI/CISH I RCTO BT I BITE RCVD I PERMIT I <br />