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Home My WebLink About91-1376 STATE OF FLORIDA City of Zephyrhills PASCO COUNTY BUILDING DEPARTMENT 1-813-788-6611 Permit N~ 13768 Type of Permit ~~ ~ ~ MEC~L Property Owners Name: fJdYz 1J~'-~A:4hJ Job Address: 5';;)'1"0 .4p.H ~/, Date .....'? - / ;:2-? / Legal Description: Sub.Div. Lot Blk. Zoning CI: DeSCriPtiOnOfWOr~~ '-<~4-h"'jVL~__/,,7~ p _~~ Energy Code Readout: Complete Plans, Specifications and Fee Must Accompany Application Estimated Cost: ~ ~ 7--.C Ob Fee: rJ... 6. (J7J ;J SIGNATU'RE 9-.-,.o-'Sz,':, "C<~ . COMPANY ADDRESS OCCUPATIONAL LICENSE #-5~ ~-'.h~ TELEPHONE # .77? CI C ~~;Lrvr~J;/ ~/JAJ ~ ~ C -6OI[Dllm":J PL~G . ELE~AL Ftr. SLB ~ Tp.Serv. """" Pre SLB Tub Set Rough In Lintel Water Meter Can FRM. Sewer Const. Pole Insul.CL Final Pool WL Pre-Meter Final All work shal! be performed in accordance with the above and all City Codes and Ordinances. ME~ICAL ""'" Breakers Ducts Insl. Compressor Final Driveway Relnspectlons: When extra inspection trips are necessary due to anyone of the following reasons, a charge of ten ($10.00) dollars shall be made for each trip. (a) Wrong Address (b) Condemned work resulting from faulty construction (c) Repairs or corrections not made when inspection called for (d) Work not ready for inspection when called. The payment of reinspection fees shall be made before any further permits will be issued to the person owning same. TANK REMOV ALS REMEDIATION ASSESSMENT 1"1. COMPLIANCE T.RAC. ENVIRONMENTAL SERVICES INC. March 12, 1991 City of Zephyrhills Building Department 5335 Eighth Street Zephyrhills, Florida 33540 Re: Permit for Underground Storage Tank Removal Gentlemen: This will authorize Jason Stewart to act on my behalf, to pull a permit for the excavation of an underground storage tank located at: Don Olson Firestone 5240 Gall Boulevard Zephyrhills, Florida ~ ; --- . . --~ . - Glen A. Wills, President License #PC CO 45194 STATE OF FLORIDA COUNTY OF POLK Before me personally appeared GLEN A. WILLS to me well known and known to me to be the person described in and executed the foregoing instrument, and acknowledge to and before me that he executed said instrument for the purposes therein expressed. WITNESS my hand and official seal this ~ day of ~ 1991. .~+>~~~ Notary PublIc Notary Public Sta18 of FlorIda at LMge My Commission ExpIres: september 4, 1993 P. O. Box 2230, Eaton Park, Florida 33840-2230 Phone: 813-665-5002 Fax: 813-665-4671 TANK REMOVALS DEMEDIATION n ASSESSMENT 1"1. COMPLIANCE T.R.A.C. ENVIRONMENTAL SERVICES INC. March 11, 1991 ,i Ms. Maura Sweeney . Pasco County Health Department 9930 Land '0 Lakes Boulevard Land '0 Lakes, Florida 34639 Dear Ms. Sweeney: This is to advise that Don Olson Firestone ENVIRONMENTAL SERVICES, INC. to excavate and storage tanks at the following facilities: has hired T.R.A.C. remove underground Don Olson Firestone 5240 Gall Boulevard Zephyrhills, Florida No date has been place. We will date when the scheduled. scheduled as yet, but signed contracts are in provide you with proper notification of exact customer is ready to proceed or the job is Very truly yours, T.R.A.C. ENVIRONMENTAL SERVICES, INC. ~..(l~cJ:) c..l"'aice J. Stewart Vice President JJS:np cc: Florida DER Stationary Tank Regulation Section 2600 Blair Stone Road Tallahassee, Florida 32399-2400 P. O. Box 2230, Eaton Park, Horida 33840-2230 Phone: 813-665-5002 Fax: 813-665-4671 ~ 'I'ANK REMOVAL SCOPE OF WORK AND CONTRACT - DON OLSON FIRESTONE - 5240 Gall Boulevard Zephyrhills 1. Furnish all permits, personnel, equipment and materials to remove and dispose of one (1) 500 gallon underground storage tank in accordance with' API recolluuended practice 1604 and appropriate DER r~gulations. 2. Provide backfili,~.terial fo~' excavated area to bring to original grade. '.. ,1 3. Place broken concrete in excavation and backfill to grade. 4. Provide client with tank closure assessment report and coordinate all site activities with County compliance agency. Provide deregistration of tank with State. UNDERGROUND TANK REMOVAL QUOTE PER SITE........$l,475.00 OUR PROPOSAL IS BASED ON THE ASSUMPTION THAT THERE ARE NO UNFORESEEN OBSTRUCTIONS, EXCESSIVE ROCK, CONTAMINATED SOIL, GROUNDWATER, CONCRE'l'E WITH EXCESSIVE REBAR on, OVER 6" 'l'IUCK, OR ANY OTHER OBSTACLES, THAT WILL HINDER THE REMOVAL. ALL FEES ARE BASED ON EASY ACCESS TO TANK SITE AND SIZE OF TANKS AS STATED. IF THESE CONDITIONS ARE ENCOUNTERED, THEY WILL BE HANDLED ON A TIME AND MATERIAL BASIS. PAYMENT TERMS: Payment Consideration for extending requested in advance by the forwarded within 60 days. due on completion of service. the terms ot payment should be Client. Closure Report will be ABOVE PROPOSAL AND CONTRACT ARE ACCEPTED AND AGREED TO THIS DAY OF , 1991. BY TITLE OPTIONAL CHARGES. IF APPLICABLE DISPOSAL OF ASPHALT OFF SITE......................$250.00/load SURFACE REPLACEMENT...............................$ 2.85/sq ft LIQUID/SLUDGE REMOVAL Vacuum Unit/Operator.........................$120.00/hr Disposal of Non-Regulated liquids............$ .75/gal Disposal of Non-Regulated solids.............$ 1.75/gal E ~ CtIIJl 01Jl <i!: Ill)> ~:r:! Oz :Jim N o en " r- ~ -< Z ~ n o z en " n c o c en " r- ~ n m =* O:n :JI- III ; fil ?J~ ,- CtIC3 ~ 01Jl :II en ~i!: -1"0 :JI )> :I: )> ~z mo :Jim -<-I N m:I: )>m :II." mm xm J1:I1 :Ilm ZO G'lC :0 &.om ~~~ ~ ~ "1 ~ ,:0 ~ ~ 8~~ nl o<z ':II a -A iI ~ . N >ono i" N.o ." o ,t t1'l~"'-4E ,..o~ .... ... NOiQ,.. 01:11 ,.. z;o v.;a.1n ~ ... "'l:I nn :l>NO Gl ;llJN:J:m,.. 1\w4WZfIl Om<z ",.... "" .;n:.- ,... :oor- ozo :J:Z mN zO -4 ,. ,.. "-I "-I 0.1 ~ o . N N "-I o -4E .... :or- r- >en ... n en m,.. zm <z .... :;0> 0'" zo ::J:Z nlN. zo' -4 ,.. r- en m :0 < .... 7- n ~ en 01 :;0 < .... z n n m :;0 -4 o "' ~ "'l:I ::0 o n--t ,.. o~ ,.. zz c: r-en -t I" -4 ....-4 ocn ~ ~!:;:~.-n~l~ ~ -4,zn~~I'nt; en.... 00 ~ fl: '........ -n-nll VI zo"'-n 1:) G'IZ ~51'" ~ CD.... 0:0 g D oz ~61ffi m :1>0 ,)>' ill ::0 c:... I oJ en oen m ' -c -4 G'l en ::oc -c' ~ o z en -4 o ;0 :.- G'I ,'m '"' n '7 .... ~ :0 mCZ-l xZ)>::I: ::Qos:;:m JJmm zJJOn G)-lrom ::I:m:;O mr-4 ~"OO"'l:l ;z JJ:Eo 010 ,.. <..... "-I wen C 0- ... ... On>> ZmZ -U>:;o... -0 ... -00.... en """11",,... 0....0 ::I:m:o )>0> "0 G'I -l m m JJ .;. ~ t.\) -0 n en'o -c ".. en VI -A -<> ".. n o z .... :0 "11 o "11 o JJ -l ::I: m -< m )> JJ o lH a VI o ... -... ... >00 . nCllZ' I ~....en V v. .... ,... 00;:0 o :Z:..,C: C <",n ." ............ ,.. r-n.... .... '-mo n m z )00 ... OJ .... 0.... rn ..,xZ .... ,.. Q ^ NC: I UoI en IN.... ... N ;:0 ... 0 -c .... \. .. r. o m ~ :0 n-l ~s: In -1m ~z n-l -I ~O Z ,,(/) ; -c~ o :o~ ~ om -I ,,0 : mil r C/);!1 ,.. U'J 0 f') -:0 ~ 00 ~ z)> :z: )> ... (jl r- 7 OJ I o :0 v ~m~ oG">; C:r r-~ ~~ ::!~ o~ z: . It- ... .... .;. "'l:I f') N ~ .... f') '" N o ~ OJ ".. m .... VI ~ -0 .... CI -0 ".. ,.. .... n m z en .... ;r m m D )> c o ~ ~ ~ ..... nO o % z Vlzi! o P P z p I-" o ~ ~ to ~ ~ 0) . g t--" n ~ I-" n I-" Dan Townsend & Associates, Inc. P.O. Box 157 18 North Sixth Street Haines City, Florida 33845 (813) 422-7574 -----.---" .......~.-..........~ CERTIFICATE OF INSURANCE ISSUE DATE (MM/DD/~:_I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. A4~4tl~I.. '*' PRODUCER COMPANIES AFFORDING COVERAGE COMPANY A lETTER JII.Iount Hawley Insurance Company' INSURED ~~~~~NY B T.R.A.C. Environmental Services, Inc. P.O. Box 2230 Eaton park, Florida 33840-2230 ~~~~NY C ~~~~~NY D II ~~~~NY E CQVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO lTR. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DD/YY) DATE (MM/DD/YY) liMITS FIRE DAMAGE (Anyone lire) $ MED. EXPENSE (Anyone person) $ $ 1,000,000. $ 1,000,000. $ 1,000,008. $ 1,000,000. 50,000. GENERAL liABiliTY A X COMMERCIAL GENERAL liABilITY MOL007297 CLAIMS MADE X OCCUR. OWNER'S & CONTRACTOR'S PROT. 12-06-90 12-06-91 GENERAL AGGREGATE PRODUCTS-COMP/OP AGG. PERSONAL & ADV, INJURY EACH OCCURRENCE AUTOMOBilE liABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE liABiliTY EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBREllA FORM COMBINED SINGLE $ LIMIT BODilY INJURY $ (Per person) BODilY INJURY $ (Per accident) PROPERTY DAMAGE $ EACH OCCURRENCE $ AGGREGATE $ WORKER'S COMPENSATION STATUTORY LIMITS EACH ACCIDENT $ AND DISEASE-POLICY liMIT $ DISEASE-EACH EMPLOYEE $ EMPLOYERS' liABILITY OTHER DESCRIPTION OF OPERA TIONS/LOCA liONS/VEHICLES/SPECIAL ITEMS j\CORD 25:5 (7/90) CANCI;LLA liON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL10/3CbAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. ~ · ~~.J ~ ~..L.--'''"ACO"RO_CORPO~T10N 199. CiATIFICATE HOLDER ~~h .A.~.tll't. CERTIFICATE OF INSURANCE ISSUE DATE (MM/DD/YY) PRODUCER ~.~_._. .-.-----.--..---...--..-.--- -.------..--- THIS CERTIFICATE IS ISSUED AS A MATTER Of INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Dan Townsend & Associates, Inc. P.O. Box 157 18 North Sixth Street Haines City, Florida 33845 (813) 422-7574 COMPANIES AFFORDING COVERAGE INSURED f~~~NY A AIIerican States Insurance Company f~~~~NY B Aetna Casualty and Surety Company T.R.A.C.Envirorunental Services, Inc. P.O. Box 2230 Eaton Park, Florida 33840-2230 f~T~~~NY C f~T~~~NY D ,i f~~~NY E CO,yERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD -INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO lTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DDIYY) DATE (MMIDDIYY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABiliTY CLAIMS MADE OCCUR. GENERAL AGGREGATE $ PRODUCTS-COM PlOP AGG. $ PERSONAL & ADV, INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Anyone lire) $ MED. EXPENSE (Anyone person) $ OWNER'S & CONTRACTOR'S PROTo AUTOMOBILE LIABiliTY ANY AUTO All OWNED AUTOS SCHEDULED AUTOS A X HIRED AUTOS X NON.OWNED AUTOS GARAGE liABILITY 01-CC-814005-1 COMBINED SINGLE $ 1,000,000. liMIT BODilY INJURY $ (Per person) 12-13-90 12-13-91 BODilY INJURY $ (Per accident) PROPERTY DAMAGE $ -.- EACH OCCURRENCE $ AGGREGATE $ EXCESS LIABiliTY UMBRELLA FORM OTHER THAN UMBREllA FORM B WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY 094c021 04282 8caa 12-08-90 STATUTORY LIMITS EACH ACCIDENT $ 100,000. 500,000. 100,000. 12-08-91 DISEASE-POLICY liMIT $ DISEASE-EACH EMPLOYEE $ OTHER DESCRIPTION OF OPERA TIONS/LOCA TIONS/VEHICLES/SPECIAL ITEMS CEf)TIFICATE HOLDER CANCEL~A ,,'ON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WilL ENDEAVOR TO MAIi!-O/30DAyS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUT;a;: ORIZE REPRESENTATIVE , J I r;--" t. ~.:1JI:-..-~ , ~~~ORD CORPORATION 1990 : -..-.-..-----..-'",'.. ..--. _A~~F1J)~5-S_E!~~_____________.