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SANJ O A Q U I N Environmental Health Department <br /> COUNTY- <br /> 7. See 'Sampling Protocol for Routine Tank Removals' and 'Verification Analysis' on page <br /> 6 and 7 of the permit application for required analytical tests and number of samples to <br /> be taken and witnessed by EHD. <br /> 8. A copy of the Fire Department permit must be submitted at the time of removal. <br /> 9. In addition, the following information must be submitted within 30 days after the UST <br /> removal date: <br /> a. Analytical results: only results that come directly from a third party California <br /> certified laboratory with affixed chain of custody will be accepted by EHD <br /> b. UST Tracking Record Sheet and/or Tank and Piping Hazardous Waste Manifest <br /> c. Tank Closure Certification Form (DTSC Form 1249) <br /> d. Hazardous Waste Manifest for rinsate and residual product <br /> e. Backfill Excavation Certificate <br /> 10.Permit expires 180 days from the date of approval. If an extension to the expiration <br /> date is required, a written request must be submitted to this office prior to the expiration <br /> date. <br /> If you have any further questions, please contact me at (209) 468-3432. <br /> Thank you, <br /> Paul Nso <br /> Environmental Health Specialist <br /> cc: John Bubica, 701 South Ham Lane Suite C, Lodi, CA 95242. <br /> 2 of <br />