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HomeMy WebLinkAboutBUSINESS PLAN (2) · .: CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT M. R. KELLY FIRE CHIEF September 12, 1994 1715 CHESTER AVENUE BAKERSFIELD. 93301 326-3911 A & A Investments Attn: Rose Neumann 151 Pasatempo Drive Bakersfield, CA 93305 CLOSURE OF 1 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANKS LOCATED AT 1400 SUMNER STREET. PERMIT # BR-OI02 Dear Ms. Neumann: This is to inform you that this department has reviewed the results for the preliminary assessment associated with the closure of the tanks located at the above stated address. Based upon laboratory data submitted, this office is satisfied with the assessment performed and requires no further action at this time. If you have any questions regarding this matter, please contact me at (805)-326-3979. Sincerely, ~ J:L ¿j~ £,V\ "' Howard H. Wines, III Hazardous Materials Technician HHW/ed cc: C. Cornet, KES R. Huey 1 (( I I I ¡ .£- J!;!l- /~ ~LL 0/'(. OF KERN BACKHOE SERVICE, INC. _. September 1, 1994 Jy~c /Sfp ~/VS'D 02 " Ij..t ,? '1<t'ir4 'A4. :..q 7': DI IE: Mark Turk CI1Y OF BAKERSFIELD HAZARDOUS MATERIALS DWISION 2130 "G" Street Bakersfield, California 93301 REGARDING: Underground Tank Removal, Permit No. BR0102 (KES Project No. 94-3522B) Dear Mr. Turk: Regarding the above referenced underground tank removal for A&A Investment at 1400 Sumner Street, Bakersfield, California we are forwarding the following items for your records. 1. Soil sample analysis results Zalco Laboratory Nos. 40709-1 and 40709-2. II IJ" I \ I I 2. Sample chain of custody documentation. 3. Non-Hazardous Waste Hauler Record No. 114313. 4. Certificate of Destruction (Golden State Metals No. 10651). Feelfree to contact Mr. Frank Rosenlieb or the undersigned should you require additional information regarding this project. Sincerely, CORNETT, Lead Technician DCC:bd Enclosures C:lm'S] \CRAIG\LE1TERS\COB2 y.] Post Office Box 5337, Bakersfield, California 93388 . (805) 589-5220 In California . (800) 332-5376 K¡ e - ZALCO LABORATORIES. IN·C. Analytical & Consulting Services ~ Kern Environmental Services POBox 5337 Bakersfield, CA 93388 Attention: Craig Cornett Samp 1 e: Soil Sample Description: Job # 943522B, A&A Investment, Sumner Street 40709-1 2 Feet Under Tank 40709-2 6 Feet Under Tank Sampled by Craig Cornett on 8-8-94 Laboratory No: 40709 Date Received: 8-9-94 Date Reported: 8-15~94 -1 -2 !!19ili. mg/kg MRL Volatile Aromatic Hydrocarbons Benzene < 0.005 < 0.005 0.005 Toluene 0.0052 0.006 0.005 Ethyl Benzene 0.010 < 0.005 0.005 Xylenes 0.025 < 0.015 0.015 Method: EPA 8020 Date Analyzed: 8-12-94 !!19ili. mg/kg MRL Total Petroleum Hydrocarbons as Gasoline , 10 < 10 10 Method: DOHS Luft Manual Date Analyzed: 8-12-94 MRL = Minimum Reporting Level Jimk ~ Lab Operations Manager JE/sgw 4308 Armour Avenue Bakersfield. California 8330B (805) 395-0539 FAX (805) 395-3069 CHAIN OF CUSTODY RECORD C{ O~7£) 1, ' Joo No·ti" .l('ZL.~ dienl Name: A.( ¿, jrvt,Q/' t'ktf~ ~ ,,'.,',' """:""'," / ,·"',Hi ".> '.,..,' ',' " " <> "'>;H ..', l>mjce! Name .5 ,/ ~ 1'Ve?e- 057: ... ,",..'.'.',' .',., > '",P,,\ ~ ><" .',..,. ,'".' .,' Sampler(s) C cP//I,("~ ~ Projce! Manager c.. CP~~ '.,.." "".} ....:..', ',',:r''': ' 'j~c, ,," '::' TIE!: ::' ;.::' -............ ~ ~ 1);11'(: ':;,:,:::,::, N~.:':::,·: . ., ',',."..",' ., '.'"",...,. H" ~ .. u.. "'.. Sõlmplç¡J , Silmplod (:O/llI)()O;ilC: :,:" (¡r',', /:,' ':i ¿111"iI1l~~ ':: ",' ".',' ','" " " :.', , ....' or'Grul.l .... ~ .,.,,>.',:,..' '.'.,.'" .,..,. ',',''':' 'I 8" 8'" --< "I I !:/ J.A.. £ Olt... - 2. r (/~PM? T~ I 1 { 'l.. ,?" ~'ç¡'t I' /"' " , (/ tV¡';)1Id riJN~ I '-{ "t <)t;,I(.. - I , '. .. -. , ~ . , , IIcl;"".1 _'i¡iii', . .',. '. ',:,.:/ ...' "",'. ,~ ..." ./ ,":r',', x?- '~c/ y "3 ~ ZS'~ ncœived By / --f(¿¿Y~M IJ// £. Ctô. ~ "74 L C_-o X r-Cj-C; c/ 3 ~3s 1 -, ¡JJU U nclinqui.~héd Dy Received By I' Rdimlui.~hcd By Received lIy I :¡¡:::::¡¡::::¡:::::':,~'\~J~{(m:iW:¡~~I'~'I¡y¡~¡5":~~~,Œ:¡f "".. -)C~ YES NO 'I .... . KERN ENVIRONMENTAL SERVICE Post Office Box 5337 Ba/ccrsfie/d, CéJ/ifomia 9338(J (805)589-5220 In CéJ/ifomia (800)332-5376 I I Bill To: Well, Tank No. Field or Area ICJ!. P.O. BOX 5295 . BAKERSFIELD, CALIFORNIA 93388 (805) 589-5220 NON-HAZARDOUS WASTE HAULER RECORD TO BE USED FOR NON-HAZARDOUS WASTES ONLY M!'!' "- .~ N<? 114313 (Generator Must Complete) WASTE TO BE DISPOSED ~ Type (~-dr~v~ ~ Generating Location /'11>1:> Special Handling Instructions: o Gloves, 0 Goggles 0 Other Quantity OI1.N- T t wlt- !.\. DESIGNATED FACILITY .., Name Go"o~ ..J7~ t'W--T#(,S Address ZOC ð G:.. µvA/bJC~ City. State, Zip BM~/GGq CA Phone '7M/)(, Çv""~ p(..~ c¿ / r ~ Name 4 ~ /} :1:ïVver?Ã4?~ If Field Address /.(/ ¡7.4.sA~NJI>¿) /)JL City, State, ziPB#I1C~<P/C~ C4- '1?3oS PhoneØ'--» :)23-/3'-/1./ Order Placed By /lo.Je- /l/CvAA~/I/ Sig9fiture of Authorized Agent ~~ ìUN/#(¿UU-i. ittv /J-i,4 ht~41d...uL:J Date ' ? -? - 9<1 / ;Jt t..H', r¡-U.:77 I (Hauler Must Complete) Ticket # Unit No. / Name (é6S Address ¡P, (;). þo ~ .s3.J ? City, State, Zip 1~?l:sP/~'l- C.IJ. 9~ '1g Y Phoný~ 5~" ~Zz.o Signature of Authorized Agent or Driver Pick Up Date g:'''- F, 'J '1 Time DAM o PM NOTE: This form to be used in lieu of the California Department of Health Services Hazardous Waste Manifest for NON-HAZARDOUS wastes only. REMARKS: /~/r .IT ,5'l- 01 07- e Date /«--;1 Jø~ 'Yt¡3SZ,Z.ß Time Bbls. Date DAM OPM I Quantity Received DISPOSAL METHOD: o Surface Impoundment o Landfill 0 Other Return Copy To: GENERATOR UNLESS OTHERWISE SPECIFIED o Injection NOTE: It is not necessary to send copy to Dept. of Health Services. NO HAZARDOUS FEES SHOULD BE LEVIED : I I I 5/90 ¡.. e - . ". I GOLDEN STATE METALS, INC. P. O. Box 70158 . 2000 E. Brundage Lane Bakersfield, California 93387 Phone (805) 327-3559 . Fax (805) 327-5749 Scrap Metals, Processing & Recycling 110 1 0 6 51 TANK DISPOSAL FOR Date ,19 Contractor's License No. Contractor's Phone No. DESTINATION: G. S. M. . 2000 E. BRUNDAGE LANE . BAKERSFIELD, CA 93387 HAULER: , TOTAL DISPOSAL FEE 250 .14 ¡¡¡¡:::::¡::t/m:l')i??¡¡!:!¡:':¡:::::::::::::¡::¡¡!~!¡::!::¡:::U!¡!:!¡:¡!:::::¡!:::':"':"':':'H::::::!!:!::::::::¡:!:¡:!J~j!::?:":m::::t' 550 .24 )¡¡¡}:::::):::::)::::::::):::/::¡:¡:¡:::::¡:¡:¡¡¡:¡!:¡!:¡:¡:~w~¡HME::¡:¡:¡¡?¡¡):::::/):::::::::::/:::¡¡:¡;¡¡¡¡¡:¡)::M~:¡::¡:¡::)¡:::¡::) 1000·6ft .61 ¡¡::::::::::::)))))):?:::::¡:::::::::::::::::::¡i~9.¡:::::::¡¡:¡¡::::::::¡:¡::::::::::::?:)))::,::,:?¡¡¡¡¡¡:::??:¡:::;~W:¡¡¡:: ",.,:: 2000 .97 ¡:::::¡:;)::::::???(:::::::::::::::¡:::;:::;:;;¡:::::~ii;;:::::::::::m:m:mmm:)'(();));;;:;;:::;::;:::::;1;;j;~:,; "'," 3000 1,32 :::::::!¡::m:::::m:m:m/:://::::::::::::¡!:!¡::j:j:!::::::::IWm:¡¡!j:j::::::¡¡::¡j¡j¡¡:::::::::j:j:j:!!!:/::/':::m:?:::::t:::'::::¡!:¡:i::::::::j::!j:::j;~@:¡i:U::::::!::i: 5000 2.42 ¡¡¡rr~~/rt~{~~~~t~¡t~~i;¡;;!¡¡¡rr~~~r¡¡;¡¡¡¡¡~ª~t;¡;¡;¡¡¡¡¡¡¡¡;¡¡f;;¡¡¡trf~;~;;~~~t.... .....:.:........ , Um~~ij~fr;~r¡fr 7500 3,28 t:::!n::::::::,::\)))::::::::::::::::¡:¡¡¡::¡:::::::::im§U:::\::::::::::',::::::i:ii@::::::::Y:',,:,,:::,:,:}::)@11¡U:¡?\;: 9000 3.82 :¡:::::!:::):::::?:)::::::r::::::::i:i:::::¡::::;;;::i:i:¡::::;¡:m?§'M:::¡::::¡:::i:::::::i:¡:¡:i:¡:::::i:::::::??\:):r:::f:::i:¡i::i::'¡::::i:::¡::i¡~iM::::::¡:::::iiiiii;¡ 12000 4.93 :j:¡:¡:¡:¡'it:)t::::::::::::))::::¡:gr\!!j:::::::::::::::¡:::¡:::::::::::::¡:::::,::::¡:::::¡y¡¡:¡,:;::::nn!:::!::,!::::r!:::!:tw:m;¡:;:;:¡:¡::,¡:¡:¡::¡';W¡:!Y':¡::::¡::W{ ~CTION [Y-é"LEAN & DRY (ACCEPT), OR ~ RESIDUALS PRESENT (REJECT) L~ LEL READING \ OXYGEN CONTENT SCRAP VALUE OTHER TOTAL CHARGES $ TOTAL ",,\ All fees incurred are per load unless specified. Terms are net 30 days from receipt of tank. Contractor's signature represents acceptance ofterms for payment, and confirms that tank removal complies with State laws. CONTRACTOR'S SIGNATURE CERTIFICATE OF TANK DISPOSAL / DESTRUCTION TO CERTIFY T E RECEIPT AND ACCEPTANCE OF THE TANK(S)AS SPECIFIED ABOVE. ALL MATERIAL SPECIFIED WILL BE C PLETEL Y R C AP RE~YCLlNG PURP SES ONLY. WHITE - Contracto. Copy . YELLOW - File Copy . PINK - Permanent Copy L ' A' Bakersfield Fire Dept.. "'AZARDOUS MATERIALS DIVISI~ UNDERGROUND STORAGE TANK PROGRAM PERMIT N;;ßR "O/Oð I " ~··~;t··' ".... ,'" '(3-;-'"~t i:t.t',,¡,) , " ". .... I, ., PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORA~,È TANK :::> PHONE No. , .32:5- 13yi-( (~£~"'ïJM~ CITY FSrLsA-r? ZIP CODE ,:)3.3~ q ADDRESS/tOD S:)m,J¿.€. ZIP CODE ".:33'~.s-APN, CROSS STREET CONTRACTOR INFORMATION COMP ANY ~ ç;;:arc.fi 17oU~i::.'Y7>1L. Su21ìONE No. ADDRESS 'Po ~)( ~ 7 INSURANCE CARRIER ,cx-""(f"qJ co k!r!C-""Y2-. , . ~~ 5220 LICENSE No. t( 3 2372- CITY 'B~SFl-{). ZIP CODE C:;:>:3 -:s B~ WORKMENS COMP No. IÆf C- 5'8z37.,'2.. PRELlMANARY ASSEMENT INFORMATION COMPANY I\.Cöú€" ADDRESS INSURANCE CARRIER PHONE No. LICENSE No. CITY ZIP CODE WORKMENS COMP No. TANK CLEANING INFORMATION COMPANY ~¿ As Cô~ré9Z- ADDRESS S:;ITY WASTE TRANSPORTER IDENTIFICATION NUMBER 2- 0;> cI {p NAME OF RINSTATE DISPOSAL FACILITY c;.. (ßSo~ ..:::tVút'f2~~ ADDRESS ~D &::IF" Cðn?/J1~~4-L- ~. ' CITY BtLSF'C--D. FACILITY INDENTIFICA TlON NUMBER c..A.-D ~ 80 Sf; 3 /7'7 PHONE No. ZIP CODE ZIP CODE "'::>33c::8 TANK TRANSPORTER INFORMATION COMPANY~tz..0' ~o~ 5ÚC. (¡((cPHONE No. ~ -:>--Z2c:> LICENSE No. 432372- ADDRESS ,-pc:::> Be:>" 5.3'3 ~. 'CITY 8¿¿SA.D. ZIP CODE <::)33 ~ ~ TANK DESTINATION GoU)..;;:-.c.f ~1-f\7 ~ Mc:::::.1 I\,-S ' ~CL-tµr., , TANK INFORMATION TANK No. AGE 1..( 3{rz-s. VOLUME S-oo~. CHEMICAL STORED C.....~OL.J",..:> .;: DA TES STORED 1>1 - l(p> CHEMICAL PREVIOUSLY STORED J.J:cú .¿- THE APPLICANT HAS RECEIVED. UNDERSTANDS. AND WILL COMPLY WITH THE ATTACHED CONDITIONS OFTHIS PERMIT AND ANY OTHER STATE. LOCAL AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE. IS TRUE /_*~~~ Cµrzc5 "D;A:i"2-f""71o,.J BY.::.-~ APPLICANT NAME (PRINT) THIS APPLlCAJION BECOMES A PERMIT WHEN APPROVED . 'c ;.. ' " PLOTPlAN.;__,c,;.,. . , Plot Plan must show the fOllowing:í.Ç{Z~·?'Roadsarìd olleys;C·'~,iA.~~,,:~h " ;::'.2.,,::'.".: buildings" -. ¡::; "., , ·',,~C:~"4:':::t.:::;',~.rÞt~) N 3. location of tanks. piping, and dispensers 4. utilities 5. SCALE ~:~':'6;'''"'~~,'>;'water wells (if on site), ,::;:'.~:;:. " . .' .- 7. èmy otherrelevent informaflon \ f2r..n(.C¡ {...( ~ (,...o"í'" /' \ ;I I I ! I I i I ¡ ! I I I óikr~ ~~ "''' . '<..4'_,1"" . t' " ~; ,-.} ~... , k.' .. " ß~ ï:;oo~ 500~. -r~~ ~ , , '-, lY.öO SJMLf<siZ- 5, . D~ -'-I I I I ~', ' A'J;,,", ,', ' AvJ~I~C7 ,;~.' . ,- ~. ~ - ,,,," _ :r.:; ~_. <;'L., ' .......- V /' y _ __1 I I I I 'Bc....Dc, . )t x )( J.( )( . Bakersfield Fire Dept.. ~AZARDOUs MATERIALS DIVls~ UNDERGROUND STORAGE TANK PROGRAM PERMIT No--::ßR"" 0 / Oa- f . .... , ..' t " . ~ '. PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK SITE INFORMATION SITE A. ~ A- '~Ú~M€,<.Í~ FACILITY NAME TANK OWNER/OPERATOR lúif;~ MAILING ADDRESS 51 ADDRESS/tOD ~n?,ú¿-.e. ZIP CODE -'33c::::>S- APN CROSS STREET ~ ~ PHONE No. .323 - 13t../ t-{ (~Z,J~-WM;Iþ... CITY l-=SrLSA-r? ZIP CODE 0X~3ë:<s- CONTRACTOR INFORMATION COMP ANY ~,ç;;yc.fi i?Oilt"ff::.V7'>17- Su2RONE No. ADDRESS yo ~ k' s=53 7 INSURANCE CARRIER \0<-"" f'\1..f - kf rfC-'Y2.- . ~·SZ2°llCENSE No. ¥3Z37Z-. CITY 'B~SFi-f). ZIP CODE t:::.):3 ~ i?ß WORKMENS COMP No. 1A.fc.... 5ßZ37~2 PRELlMANARY ASSEMENT INFORMATION COMPANY I\.CbÚ~ ADDRESS , INSURANCE CARRIER PHONE No. LICENSE No. CITY ZIP CODE WORKMENS COMP No. TANK CLEANING INFORMATION 'COMPANY ~¿ ~ C:O~Ti9Z- ADDRESS ' ,ÇITY WASTE TRANSPORTER IDENTIFICATION NUMBER z... C') c¡, Lo NAME OF RINSTATE DISPOSAL FACILITY G. (ßSo¡J' ..:2A.1ú('f2oc..f'M,.;~ ADDRESS' ~() ~ Cðn?/YI.---¡zq4-t- 'i::¥? CITY &L"&F'r--D,. FACILITY INDENTlFICATION NUMBER c....\D ~ßo 8~ 3 /"77 PHONE No. ZIP CODE ZIP CODE ~~30'8 TANK TRANSPORTER INFORMATION COMPANY~a..u ~o";- súC. l¡((cPHONE No. ~ -:>-Z2.c:::::> LICENSE No. '-f32372- ADDRESS "pc:> Be::> ( 533 ~ . CITY í.3~sr=t. D. ZIP CODE C) 33 g ~ TANK DESTINATION c;..oLt>~.<..Í <:517\7 G MC:::II\~S ~C.l.-(µí.., TANK INFORMATION' TANK No. AGE L..( '3 {~S . VOLUME S-DO~. CHEMICAL STORED C---Þ6ou'-:> oE" DATES ,STORED 1>( _ l(p:;> CHEMICAL PREVIOUSLY STORED Ai 't:>ú .¿- THE ÀPPLlCANT HAS RECEIVED. UNDERSTANDS. AND Will COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMIT AND ANY OTHER , STATE. lOCAL AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY. AND TO THE BEST OF MY KNOWLEDGE. IS TRUE ¡1_~~~~ Cµæc5 1:)¿fo?f'7?~ BY~ APPLICANT NAME (PRINT) THIS APPLICATION BECOMES A PERMIT WH~N APPROVED ,. ~~ .. Plot Plan must show the following: ' 11.~ . :"::2.' ,,-~,~ N 3. 4. ,5. , '">"6.,, ·7. --........... '", - r. PLOT PLAN " Roads 'and alleys . buildlngs·~' : ,....' '." "" " t"'~::··'''è~''".. I,ocation of tanks. piping, and dispensers utilities SCALE ,water wells (if on site) any other relevent information . ~ ~4."" . " __,w , " 4· ';', . ß~ T.;oD~ 0.... 500 C3'tN-. -r JIç1J (¿C. ~ I t-{oo 5-JMßee- ST' I· I I I \ \ ~."",c, ~\~ _ 1 ' -~ ( ¡/ I I j j I I ¡ I I '0, ..., !~rucl'<"'(~ L,..c;>-r 6Ïkre:.. ~0/ . .. .. J ~ i 'Be....·Dc, . x J( X .J( y y U:=;ìl ,r ð 4laAKERSFIELD FIREDEPARTMEJIÞ HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, C~ 93301 (805) 326-3979 TANK REMOVAL INSPECTION FORM FACILITY AA{:J .:E11/t!.S'i~nt.j OWNER Af Ii T CONTRACTOR ¥- ~~ , LABORATORY 24\Co TEST METHODOLOGY PRELIMANARY ASSESSMENT CO. CO2 RECIEPT ADDRESS )'-1 0(") ~tJ""nPIë:.. PERMIT TO OPERATE# CONTACT PERSON {'~(:\~ 0t<&.."'QT' # OF SAMPLES ~ CONTACT PERSON LEL% 0 02%-e- PLOT PLAN (~ '\efIC.~ oC: ¡oe~~~ ) CONDITION OF TANKS' "tAV\.-\<.- rJJi.\:S. +,-,Il QS; ~o(e~ ~' Òis i>V\1(>'òk>'A'Tecl t'"\lA R\~ , ~Q\,",^\lP"'I--\\ . ~ '" CONDITION OF PIPING ' ~otkll\. CONDITION OF SOIL veJ:"ì c:l.ì...,.......\~d 1-.' .d.c-x.u", .' \Je.~7 ~\c.L ~t'Dt:):J(,.. O~i\ COMMENTS 'ciAy l1Jy~E.- ,,' he,j()w iJ'lYl#...? g 18jqLf DATE mM...~ , -r,,\.r\::- INSPECTORS NAME /7~ {ãfÞ.~ ':)tt9~ / 'SIGNATURE ' 'tt. Bakersfield Fire Dept_I' , PERMIT No~R,o/()a- -, AZARDOUS MATERIALS DIVISI ,< c_ ,_. .' . .,,;, _ . ."~', 't- \. .1... , '\¡_ . I UNDERGROUND STORAGE TANK PROGRAM ..... . . .. . t(Q)~V PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK SITE INFORMATION SITE A., A- 1,~Úé:.5TM~,ú~ ADDRESS/tOD :5Vm,J¿.€. FACILITY NAME ~ CROSS STREET TANK OWNER/OPERATOR I ú~ MAILING ADDRESS 5 I ZIP CODE ".:33~.s- APN ' :::; PHONE No. .323 - 13L-/t-f (~z,J.."1..tr-r~ CITY F5 rLSA.. (::>. ZIP CODE ~3.3~ CONTRACTOR INFORMATION COMP ANY JLau.[ ç;:;¡.¡c.t, iZoUl"ft::.-V7Y'tL Su2frONE' No. ADDRESS 'Po '&::. X' ~ 7 ' INSURANCE CARRIER lCLf"t ~ - k! rK-'1Z- . ~~ 5220 LICENSE No. ~ '3 237 z.. CITY 'B&eC<SA-f). ZIP CODE c::::> 3 ':s ;!?~ WORKMENS COMP No. !AI c... 58Z3 7~2 PRELlMANARY ASSEMENT INFORMATION COMPANY 1\\ÖÚ¿- ADDRESS INSURANCE CARRIER PHONE No. LICENSE No. CITY ZIP CODE WORKMENS COMP No. TANK CLEANING INFORMATION COMPANY ~~ As Cò~Ti9L- ADDRESS ' ,ÇITY WASTE TRANSPORTER IDENTIFICATION NUMBER z...~"ú:> NAME OF RINSTATE DISPOSAL FACILITY G. ('ßSod ..:i::A.fÚt'(2~~ ADDRESS .q..fD ~ Cðn?/H.-1l4' 4-L-- "i:)J? CITY &LSFt-D. FACILITY INDENTIFICA TlON NUMBER ' G¡\D ~ ßo ' gª 3 /"7 '7 PHONE No. ZIP CODE ZIP CODE C::::>S3c:::>'8 TANK TRANSPORTER INFORMATION COMPANY ~f2..\.J ~O';- súC. l¡((cPHONE No. ~ -:>--Z2c:J LICENSE No. 4323 72- ADDRESS j:'c:> Be:>" 53'3"7' , CITY 3¿¿sr=t:.D. ZIP CODE <::)33 ~ ~ TANK DESTINATION 6OLD.=.ú" L51ï\ì~ 1\11=1 ,,~s ~c.L-tl,::::>r,"> TANK INFORMATION TANK No. AGE VOLUME <-( 3 0{ (2.5 . S-oo M-t--. CHEMICAL STORED C......ksou,v r: DATES CHEMICAL STORED PREVIOUSLY STORED 151- I ú;~ D~Ú'¿- THE ApPLICANT HAS RECEIVED. UNDERSTANDS. AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMIT AND ANY OTHER ST ATE. LOCAL AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY. AND TO THE BEST OF MY KNOWLEDGE. IS TRUE /_~-~~ C¡.JØ5 ~J\¡~o,.J BY.::...-::-:::-v' APPLICANT NAME (PRINT) , THIS APPLICATION BECOMES A PERMIT WHEN APPROVED ,^.,,~.:,:::.~,~.PL~T..PLAN ~~:~~:..::,; :~. H. Plot Plan must show the following: f.':~;- Roads ånd alleys:;.'\:;·;ò.;.¡P.""'¡.....11· , " . .~ ~ r~,.,~:;.p2~ '.~:~:'b' ' "Idl ' ,~~. ,:,.;:,t,: '~-;.·..·-_~·"....,?-1:_~~\~;}~::~~.·~'~..1"~{~.~,!>' ':":;"!.. . "" ,.¡."",.~.,~;: . /¡.~.. 1¡ ..-+'" "''-¡' ~ ¡. .. ,"" . - .. - " U f1gs..,.c -. . -' .- f ',' "",,' ~.,."."': . ......... ....,....- l.~i:",. ., ~"'~' \'/' ,t~N ·'i· 'y, ·l"... ,'. 3. location of tanks. Piping, and dis,pensers "l \.\~. ; (; i ~ 1 ' H _.- ~i' il J ;4. utilities '¡ , ;,'",/.,.~./. 5. SC' ALE t_'" _../ ~......c , . >:'. '. (:;\::6. - ".~: water wells (if on site) . ",,' ~,~; 7: . any other relevent inforincîtion' -_.,~,,----> s í2r-nç.Ç¡ (.[ ¿:, {..;.o-r 5 &~~ ß~ ' í)oD~ 500~. I~¡¿' ~ D~ 1Y.c:>O .5..;>M.úez" sr, I I I I ~" . Þ0j, . A~NI,~{7 ,;~, _ _1 , I I I ¡ I ! I ){ i I 'Bc..-'Dc, '. x ..I( )( )( -< .Ft.. '. "",,-,- . .. .. ,~ r'i '. -" ':¡..'" ... , .. ;,' '" V /' X'