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HomeMy WebLinkAboutPermit File 1911 23rd Street L"r Y Q _ City of Anacortes Permit#: BLD-2009-0012 904 6th Street Issue date: 01/22/2009 P.O.Box 547 Expire date: 03/23/2009 1.??' :c Anacortes, WA 98221-0547 tag' (360) 293-1901 Colt.— Job Address: 1911 23RD ST Permit Type: Demolition Permit ANACORTES WA 98221-2429 Project: APN: P57605 Remarks: Decommission removal of one 500 gallon underground heating oil tank. Owner: SCOTT OGLESBEE Contractor ULTRA TANK SERVICES Address: 1911 23RD ST Address: PO BOX 30076 ANACORTES WA 98221-2429 BELLINGHAM WA 98228-2076 Phone Phone: (360)815-5361 License#: ultratso33ck General information: Fees: Total Calculated: Adjustments: Deposits/Receipts: Total Due: THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY Jan 07 09 0143p Ultra Tank Services, Inc 360-3982311 P2 CITY OF ANACORTES DEMOLITION PERMIT APPLICATION 1> Site Address: /9// 23 r ' ,S 1 . Assessors Account No.: Date: /-4 -to I Lot(s): Block Addition: Owners Name:5<o(- C k Its Lc C Contractors Name: l.4 TS rose_. Address: 1411 Z d 't- 5*. Address: P.© f ye 3o6 Q6, State: (.04. Zip: 9'Z2.[ State: ( Jq. Zip: 482.2.y — 3et% Phone: Contractors License: t,t,tq c,,,{—S e33 Cie-, • Phone: 34.49 - P15'- 75-90 Have Utilities Been Notified? Description of proposed demolition. How will materials be disposed? • • Water Dept.: No Pec- wn. SS rtrvt, fecoitra a (! ) Electric: - No Cable: - No pt-c- Coo frvlto� l�v �er�rouv Gas: No II J I' re.4�'$"/rtq Q r ( _Gwlc BARRICADES TO BE PROVIDED FOR PUBLIC PROTECTION,AREA MUST BE ROPED OFF! applicant's or Agent's Signature ASBESTOS WARNING Breathing asbestos is hazardous to your health. Before starting a renovation or demolition project, survey for friable asbestos materials. Notify Northwest Air Pollution A.t:thorityprior to asbestos removal or containment 1600 S. "t treet,Mt.Vernon,WA 98273 (360) 428-1617- Fire Department Appm Date: J` /2,49 9 Police Dept. Approval: /\W\71& Date: /Public Works Department Approval f�v� Date: I `7 / 0 9 Cammenrs: / r! CofJcvrakor . LT5 l vt.t_. Owner : S cJ * 031 CSb cc it-f : (-3Lo -Tts cy27 (- J Co. N CO rn O M r 0 to- a) U z v C a O cz3 r s +.. 0 Ultra Tank Services, Inc Po Box 30096 Bellingham, WA 98228 (360) 398-0134 July 29, 2009 RE: ERTS NO. 610448 @ 1911 23`a st Anacortes, WA To Whom It May Concern: On January 12th 2009 Ultra Tank Services,Inc was contracted by Scott Oglesbee to decommission and remove a underground heating oil tank at 1911 23rd St in Anacortes, WA(see permit and decommissioning report-Appendix A). After removing the tank we noticed there were signs of heating oil in the soil around and under the tank. Ultra Tank Services,Inc contacted Scott and explained that there were signs of contamination and that we recommended taking a soil sample which Scott agreed to do. We also provided Scott with the information to contact DOE about the release which he also did. Upon receiving the soil sample report which showed a result of 12500mg.kg of heating oil,well over the clean up standard of 2000 mg/kg(see Appendix B), Scott agreed to do a cleanup. On June 29th,2009 Ultra Tank Services,Inc returned to 1911 12rd St in Anacortes,WA and removed 10.65 tons of diesel contaminated soil from the tank pit. The contaminated soil was taken to Cemex in Everett WA and was incinerated(see disposal slip—appendix D). We also collected(4)soil samples. The first sample 1911-A was taken on the west wall at a depth of 4'. The second sample, 1911-B,was taken on the south wall at a depth of 4'. The third sample, 1911-C was taken on the East Wall at depth of 5'. The forth sample 1911-D was taken from the Floor at a depth of 6". (see figure#1 for soil sample site map).Also see soil sample results—appendix C). All samples were taken and placed in clean sampling containers provided by Edge Analytical in Bellingham,WA. They were cooled with ice in a cooler and hand delivered to Edge Analytical who are accredited by the Dept of Ecology. The soil sample data shows that all samples came back under the cleanup standard of 2000 mg/kg for diesel. Ultra Tank Services,Inc also took(3)photos of the cleanup process. Photo(1)(2)&(3)were taken after the contaminated soil was removed. (see photos—appendix E.) In conclusion,all soil sample laboratory analytical data meets the appropriate MTCA A cleanup levels, therefore the site does not pose a threat to human health or the environment. Sincerel , OP ur S ThL, George W. et Vice-President Ultra Tank Services,Inc 360-815-7540 cc: Department of Ecology Scott Olesbee Anacortes Fire Marshall File Phone:(360)398-0134 Fax:(360)398-2311 Appendix A Phone: (360)398-0134 Fax: (360) 398-2311 ULTRA TANK SERVICES,INC. OFFICE PH: 1-360-734-7611 P.O. BOX 30096 Cell 1-360-815-7540 BELLINGHAM,WA 98228-3096 FAX 1-360-734-1875 January 14,2009 HEATING OIL TANK DECOMMISSIONING REPORT Decommissioner's Name: George Willet. Firm's Name :Ultra Tank Services,Inc. Decommissioner's Mailing Address : P.O. Box 30096 Bellingham,WA 98228-3096 IFCI Underground Storage Tank Decommissioning Certification Number : 1060046-U2 Address of Property Where the Tank is Located: 1911 23rd St Anacortes WA Approximante Size of the Tank or Dimensions : 300 Gallons Approximate Age of Tank :25 Years Last Known Contents of the Tank : Heating Oil Date of Decommissioning :1-13-2009 Type of Decommissioning : XX Removal Abandonment in Place Removed and Replaced with a New Tank If Abandoned in Place, Specify Type of Inert Fill : Concrete Slurry _Sand Foam Decommissioner's signature : /( G7 A- (Lr< dd (✓t1 TINA Comments : Upon removal of the underground heating tank at the above address,there was signs of contamination around and under the tank. Ultra Tank Services,Inc contacted the home owner and explained that there had been a release of heating oil. UTS then supplied the home owner with Department Of Ecology's Toxics Cleanup Programs phone number and explained that they are required to report the release with in 24 hours. UTS also explained that a soil sample should be taken to confirm if a cleanup needs to be done.The home owner agreed,so a soil sample was taken from the bottom of the tank pit and submitted to Edge Analytical. Edge Analytical will run a Diesel Extended analysis for heating oil. THIS PERMIT TO BE DISPLAYED AS REQUIRED G1 "0 • � " PERMIT No. ANACORTES FIRE DEPARTMENT + 1891y' ',cot SPECIAL PURPOSE PERMIT In accordance with the Uniform Fire Code, Article 4, Section 4.101, and the provisions of the Fire Prevention Ordinance adopted by the City of Anacortes, Washington, this permit is hereby granted for DECOMMISSION & REMOVAL OF 500 GALLON UNDERGROUND HEATING OIL TANK LOCATION CONDUCTED BY Address 1911 23rd Street Company Name Ultra Tank Services Telephone 360-815-7540 Telephone „ C- Business Address PO Bos 30096, Bellingham, WA 98228 Owner Scott Oglesbee George Willet CONDITIONs/RESTRICTIONS 1 . Perform locate. 2. Expose tank. 3 . Inert after empty. 4 . Meter for inert status and document. Contact Fire Marshal Dan Harju (661-3437) . 5 . Photo site, post removal and file with Building Department. This permit is issued on the condition of compliance with all Fire Codes and Ordinances as adopted and any conditions listed above. Signature of Requestor !„� G4s4i� Signature of Fire Officer n:. r."zr ,F; ,,'_.,., Issue Date January 8 , 2009 Expira[ih Date January 30 , 2009 Appendix B Phone: (360)398-0134 Fax: (360)398-2311 ;•SatctliA �r?�c • • -= Burlington WA 1620 S Walnut St-98233 .' v ='r? s Corporate 0R 800.755.9295•360.757.1400•360.757.1402rax - - - Bellingham WA 805 Orchard Dr Suite 4-98225 Microbiology 360.671.0888.360.671 1577rax AN _ALip1 ! CA. I, I 7- ABO3= ATO19. II ES Page 1 of 1 Hydrocarbon Data Report Client Name: Ultra Tank Services, Inc. Reference Number: 09-00410 PO BOX 30096 Project: NWTPH-D.S Bellingham, WA 98228 Report Date: 1/23/09 Date Received: 1/13/09 Peer Review: Sample Description: 1911 23rd-Tank Bottom 60" Sample Date: 1/12/09 Lab Number: 830 Collected By: Unknown • Date 1/16/09 Analyzed By: BCV Cleanup Parameter Result Flag DF Level POL MDL Units Method Batch Comment DIESEL(C12-C24) 12500 10 2000 500 25 mg/Kg NWTPH-Dx/3550B Dxsoaona HEAVIER OILS(>C24) ND 1 2000 50 40 mg/Kg NWTPH-Dx135505 axt000lle Notation ND-A result of-ND-indicates Nat the compound was not detected above the Lab's Method Reponng Lapel-MRL PDL=Practical Quanlilaton Limn M the lowest level that can be acheived within specified limbs of precision and accuracy during routine laboratory operating conditions D F-Dilution Factor Cleanup Level-The regulatory time or Method A Cleanup Levels(ATCA Cnactorlla440 WACI wnl mMmts In the soedded mettle.Amended Feb 12.2001 The Cleanup level for Gasoline Range Organics(ORO)Is 100 mg/Kg for gas mixtures without benzene and when the total ethylbenzene,toluene and xylenes are less than 1%of the gasoline concentration.The Cleanup level for GRO is 30 mg/Kg for all other mixtures. If you have any questions concerning this report contact us at the above phone number. Form.cHCID.rpt iA-74:4:121N:r 41 ., • ANALY 't ' CAL ABORATOMES Page 1 of 1 QUALITY CONTROL REPORT SURROGATE REPORT Reference Number: 09-00410 Report Date 01/23/09 Lab No Analyte Result Qualifier Units Method Limit DXS 090116 — _ _ 1331 O-TERPHENYL 73.0 741A/TPH-Dx *Notation: A surrogate is a pure compound added to a sample in the laboratory just before processing so that the overall efficiency of a method can be determined. The Acceptance Limits(or Control Limits)approtdmate a 9954 confidence(Mental around the mean recovery. CHAIN OF CUSTODY I ANALYSIS REQUEST (PLEASE COMPLETE ALL APPLICABLE SHADED SECTIONS) PAGE OF REPORT TO: ULTRA TANK SERVICES BILL TO: ULTRA TANK SERVICES FOR LAB USE ONLY _r.y""- "., ADDRESS: PO BOX 30096 ADDRESS. REF# AN A LY T I C A L LABORATORIES CRY: BELUNGHAM STATE: WA ZIP:98228 Oro. STATE: ZIP. CHECK REGULATORY PROGRAM Corporate knit GEORGE WILLET PHONE: FAX ❑ SAFE DRINKING WATER ACT 1620 S Walnut St Burlington,WA 98233 PHONE:734-7611 FAX 734-1875 P.O.u: AnN: ❑ CLEAN WATER ACT 1.800.755.9295 EMAIL' gwillet@earthlink.net ❑VISA ❑Mrc ❑ME EXPIRES / ❑ RCRA / CERCLA Microbiology PROJECT NAME: CARDp ❑ 805 W. Orchard Dr.Suite 4 OTHER Bellingham,WA 98225 ANALYSIS REQUESTED INSTRUCTIONS TURN AROUND TIME REQUIRED 1, USE ONE LINE PER SAMPLE LOCATION. 2. BE SPECIFIC IN TEST REQUESTS. gi STANDARD 3. CHECK OFF ANALYSIS TO BE PERFORMED 0 HALF-TIME(50%SURCHARGE) FOR EACH SAMPLE LOCATION. 0 QUICKEST(100%SURCHARGE)PHONE CALL REC. co u.4. ENTER NUMBER OF CONTAINERS. 0 EMERGENCY(PHONE CALL REQUIRED) O IR CC Z SAMPLE ID LOCATION GRAB/ MATRIX DATE TIME NC 2 0 SPECIAL INSTRUCTIONS/ 1 / �� COMP. (' Z 0 CONOmONS ON RECEIPT (7p l( 23 rd TwA-IL_ d.fFav+. a ,oj( /-/2-7 /!:[b ® ❑ ❑ ❑ ❑ ❑ 0 ❑ ❑ ❑ ❑ ❑ ❑ ❑ 3--r El El ❑ El _ ' ❑ ❑ ❑ Q ❑ ❑ ❑ _ B ❑ ❑ ❑ ❑ ❑ ❑ ❑ ' ❑ ❑ ❑ n n El n o ❑ 00 09-04 o ❑ ❑ 0I0I01010 _ SAAPLED SY: PHONE: i FAX EMAIL: (TOTAL CONTAINERS SAMPLE RECEIPT REQUESTED(MUST INCLUDE FAX OR EMAIL) 0 ag^' 03 Ca YES No NIA RELINQUISHED BY /J�) DATE TIME E ED V DATE TIME CUSTODY SEALS INTACT ❑ ❑ ❑ ,/,,,,..&2, /-tz-c A : 3C) /`.... � `.• it•Orl +�.9 SAMPLE TEMP (CC SATISFACTORY C ❑ ❑ SAMPLES RECEIVED INTACh r n ❑ , - C,N �. "G `k _ CHAIN OF CUSTODY&LABELS AGREE 1 , 130� = 3b ri FORM:COC 10-02-2001 Figure (1) Phone: (360)398-0134 Fax:(360)398-2311 S . Ew P f jtt 2-3 rA S 1.-. iiu a pz,p ss - 1 ~ ss- T p (JrivG LIJI� Ea-s�� �� ��ccu��Flow 7� vecp sl Oc p q rd 5 Appendix C Phone: (360)398-0134 Fax: (360)398-2311 Burlington WA 1523 5!',..In t 5, 98223 . Ch-u 655 755 3295•3E1 7�':45.3 a 5550 2' 1402ia, `n 4gi:ta _ �_-ghe .535. _`_:= S.' c - .i-C" .C:C•_31 ET" IJ/%: ANALYTICAL LABORATORIES Page 1 of 1 Hydrocarbon Data Report Client Name: Ultra Tank Services, Inc. Reference Number: 09-09518 PO BOX 30096 Project: DX Rollin rLh3R:.�n(�r Q$��.R....�., o....,..a RZ�rtiraZ/�tLnOI aaxa axa Date Received: 6/29/09 Peer Review: Sample Description: 1911 A-West Wall Sample Date: 6/29/09 , Lab Number: 19985 Collected By: Unknown Date 7/6/09 Analyzed By: HY Cleanup Parameter Result Flag DF Level PQL MDL Units Method Batch Comment DIESEL(C12-C24) ND 1 2000 60 25 mg/Kg NWTPH-Dx3550B D55090100 HEAVIER OILS(>C24) ND 1 2000 50 40 mg/Kg NwTPH-Dx3550e oxs 0amos Sample Description: 1911 B-South Wall Sample Date: 6/29/09 Lab Number: 19986 Collected By: Unknown Date 7/6/09 Analyzed By: HY Cleanup Parameter Result Rag OF Level PQL MDL Units Method Batch Comment DIESEL(C12-C24) 83 1 2000 50 25 mg/Kg hWTPH-Dx3550B Dxs09079s HEAVIER OILS(>C24) ND 1 2000 50 40 mg/Kg NNITPH-Dx35508 D1L5-M0Too Sample Description: 1911 C-East Wall Sample Date: 6/29/09 Lab Number 19987 Collected By: Unknown Date 7/6/09 Analyzed By: HY Cleanup Parameter Result Flag DF Level POL MDL Units Method Batch Comment DIESEL(C12-C24) 242 1 2000 50 25 mg/Kg NWTPH-Dx3550B oxs_Mmas HEAVIER OILS(>C24) ND 1 2000 50 40 mg/Kg NNmPH-Dx355013 0xs_090706 Sample Description: 1911 D-Floor Sample Date: 6/29/09 Lab Number: 19988 Collected By: Unknown Date 7/6/09 Analyzed By: HY _ _ Cleanup - Parameter Result Rag OF Level PQL MDL Units Method Batch Comment DIESEL(C12-C24) ND 1 2000 50 25 mg/Kg NWTPH-Dx3550B Dxs_remoe HEAVIER OILS(>C24) ND 1 2000 50 40 rag/Kg NWTPH-Dx35508 ox5Mg7es Notation: NO-Aresult or'ND"indicates that the compound was act detected above Use Lab's Melhatl Repalirg Land-MRL POL=Practical Ouantdaoon Limit is the lowest level Mat can be acheried WINO spealledlimits of precision andaccumoy doing routine labcrdoyoperating canons D F.-Dilution Factor Cleanup Level-The regulatory heifer Method A cleanup Levels(MICA Chaper17331owAD)contaminants in me speeded rteek.Ammtled Feb 12A01 The Cleanup level for Gasoline Range Organics(GRO)ie 100 mglKg for gas mixtures without benzene and when the total ethylbenxene,toluene and xylenes are less than 1%of the gasoline concentration The Cleanup level for GRO d 30 mg0(g for all other mixtures. If you have any questions concerning this report contact us at the above phone number. Form cHClD rpt • t. tor ANALYTICAL LABORATORIES Page 1 of 1 mer QUALITY CONTROL REPORT „irkV�r=x , SURROGATE REPORT Reference Number: 09-09518 Report Date: 07/08/09 Lab No Anatyte Result Qualifier Units Method Limit DXS_090706 19985 O-TERPHENYL 94 % NWTPH-Dx DXS_090706 19986 O-TERPHENYL 97 % NWTPH-Dx DXS_090706 19987 O-TERPHENYL 198 % NWTPH-Dx DXS_090706 19988 O-TERPHENYL 98 % NWTPH-Dx *Notation A surrogate is a pure compound added to a sample in the laboratory just before processing so that the overall efficiency of a method can be determined. The Acceptance Limits(or Control Limits)approximate a 99%confidence interval around the mean recovery CHAIN OF CUSTODY / ANALYSIS REQUEST (PLEASE COMPLETE ALL APPLICABLE SHADED SECTIONS) PAGE OIF REPORT Tp: ULTRA TANK SERVICES • BILL To::ULTRA TANK SERVICES • FOR LAB USE ONLY Apaaess: PO BOX$C096 A6'oReas: . .. . REtyk cci A N A L�Y�I"'i'G A Y. LAaaAATOA:19B City: BELLINGHAM: BTAlLWA;;•,;Ztos,98228 brie: . ' .STAT.:,., i10:,',. .,.CHEQKREGUTAYORYPROERAM Corporate ATTN:,GEORGE WILLET, ', .PHONE:'" `FAX : ❑ SAFE DRINIONG WATER A'cT 1820 S Walnut St PHONE: 734s7811 pwc.734=1B7tf' � P.o.il: Ate; Burlington,WA 98282 . ❑ ' CLEAN WATER ACT . 1.8E0,755,9295 eaudwfllet@earthlink.net: ' , ' ; 0 vim MIC ONE' oot,m s i . [. 'RCRA / CERCLA ; . Miorobioloav •Roma NAME: . oARDN .. [� OTHER 805 W.Orchard Dr,Suite 4 . Bellingham,WA 98225 ANALYSIS REQUESTECI INSTRUCTIONS TU- MOUNti TIME REQUIRED • 1 ` I. USE ONE LINE PER SAMPLE LOCATION. it a... ARD 2. BE SPECIFIC IN TEST REQUESTS. ' ' . 3. CHECK DPP ANALYSIS TO BE PERFORMED r HALF-TME(50%SURCHARGE) ' • . .' . ,I FOR EACH SAMPLE LOCATION. C3 Quickest(100%SURCIMRGE)PHONE GALL PEo. . :1 , 4. ENTER NUMBER OF CONTAINERS. C 4 EMERGENCY(PHONE CALL REQUIRED) `4f�� �+ SAMPLE ID i LOCATION MATRIX ( DATE TIME N e _ t GRABi i 6 SPECIAL INSTRUCTKONSI COMP. If f Fy COND7T101VS�7 RECEIPT 1 If/( ':. A ' jLbeSf 'u.9 1 : ' r 5SaiI� Lif 7!:«, '.LS1 ❑ : D. : El ! El • -❑ ❑. ,I, 2 19(.(,:_., le. :i45m46;.; L.A91x.C( ' ' i Set 1 . 6,4 9 //:- :'. ':(u51 ❑'''7 .: '. CT: ❑ i . ❑ ',':❑ ❑. ' . 3 (5'// ' .� .1 ei.5 �.A..) ,J.l all 6 �- I/.20:. '�`.af 0 ❑ ' ' ❑ . I• ❑ 0 0 . . 'C 0 CI . a El ❑ . I ElEl ❑: B I , . El El . ❑ .1 El . ❑ .. ❑ l: ❑ 09-01 ��'�''! C ❑ ❑ .. 1,99.5 8gg 1 ! ❑ ❑ . SAMPLED aY: I PHONE: I FAX: EMAIL: 4TOTAL CONTAINERS SAMPLE RECEIPT REQUESTED(MUST INCLUDE FAX OR EMAIL) 0 YES NO NM 1 RELINQUISHED BY DATE �TIME RECEIVED EY DATE TIME CUSTODY SEALS INTACT'� C 0 p .'`/.� p.� '�� ,4� f f ,', SAMPLE TEMP / °C SATISFACTORY ❑ ❑ SAMPLES RECEIVED INTACT ❑ CHAIN OF CUSTODY&LABELS AGREE El YORM:COC IO O2.20tw �� • Appendix D Phone:(360)398-0134 Fax: (360)398-2311 CC-RICx RR ,Wtio 13 1876045797 Location: 1876 - Customer. 3042112 ULTRA TANK SERVICE INC Qty= 4.40 06/30/2009 Order. EVERETT WA 98213 191123RDSTANACORTES- - ---- ---- - LB Won TON TO EVERETT SOILS G 18,400 8.35 9.20 Jotdt: NWmH-as T 9,600 4.35 4.80 P_O.: 09-00410 N 8,800 3.99 4.40 Product 1192508 'Predetemdned Tare , CLASS 3 SOIL DUMPED BY TON Today Loads: 1.00 • WHITE FORD F450 Today Qty. 4.40 Carrier. FUEL SURCHARGE APPLIES • Vehicle: 2030804 1876-4.EVERETT SOIL GENERIC Received: IN OUT 10:29 am _ Catatonia NWaWmY mks mSW.pa..a,m.rma We4 Gmtlhm40inA0eOlp9mm BoNeY�a.ry�aSOeRmGOG`Yv/ala.Ci,kP�mYrt.d,m _ d4.0... ➢...sa dmapotImnq.tle�revers aM®laUOeilytmnpmsansta Nutenso .sasses m waignotom.i. a inaa"m•wesetisir sa'.m eem+.�.om watlina�"m•a�.r�.mmavm mm.smmaamm..rsawmeaenramr.a I Original SEE REVERSE SIDE FOR PRODUCT LABEL INFORMATION 1876045794. , -G I? EVERETT WA 98213 Location: 1876• 06119Y1008 - - _ Customer 3042112 ULTRA TANK SERVICE INC �: 6� - Order. EVERETT 98213 LB Via' TON. - - 1911 23RD ST ANACORTE3 _ -- - G 22,100 10.02 11.05 TO EVERETT SOILS T 9,600 4.35 4-80 Jot*: NWTPH-DS N 12,500 5.67 625 P.O.: 09-00410 a Manual Weight Product 1162808 Today Loads - GLASS 3 SOIL DUMPED BY TONS E.WiTE FORD F450 Today Ciy. Carrier. FUEL SURCHARGE APPLIES I -- _ Vehicle: 2030804 1876-4.EVERETT SOIL GENERIC IN . i Received: OUT 236 pm - raw w e.e.a �amar,mew+.e,s.m.ma+inmm.sew.wnma/m.v+ �M' =wammaummmsa.e.sae.r4+imaee�esrm .mm„.. r ,a:mwmww am� esa w � _ ��we: ®mewaammwosm,011: �.Au�.=r1Twam,ama.vme,Wpm= Original SEE REVERSE SIDE FOR PRODUCT LABEL INFORMATION li iV Photos Phone:(360)398-0134 Fax: (360)398-2311 ate* r , y .`1 ' _y.':TIC+ r .•'•-s` 0`^,,,., _ ,. l y I` t .Jf- • a r ./r l+` Picture# (1)—East Wall 1911 23`d st Anacortes, WA Phone:(360)398-0134 Fax:(360)398-2311 7 r Y A it' 0 r v;rl�' ' � ; . Qom.. 'f • r r I • \, Ir. d Picture #(2)—Floor 1911 23rd st Anacortes, WA Phone:(360)398-0134 Fax: (360)398-2311 ' ,. -ire k i v le: w r , ��(2' '' ? i '...� 's '.i.-1,. ; ' - glad ....., rk -.- . . , iiitli. ' ,04.-7: '--,‘ ti4-,..,'N.•-• ,--, 'i,..tifigo,4,,,,,,,' ' '-, :"T' '- .":-/-',' " .-. • :Xt�. ) "... t.;'' 'ems•`'- /4„. r - ,t aC , , .r< ` .' '. •., w. : 4 t )ili -....4' .'-' .,.'.';',411,1 :- . 7*4:* .L ' "Yi_.,,,,,. ...,... .., ....„ ..., ,f..„.•., ,..,_ ..... , ,,....,,.,.,,.......,_:..... „...... .... .... ..,,, _: 44: '. —4 ."4 '-..-.1" .. 4,4:,:e."'„,y...t, :, . , f wrc. Q.•x .'.� y- Aq '^1 a '� - • ' *t ' w f. ..' Picture#(3)—After West Wall 1911 23rd st Anacortes, WA Phone: (360)398-0134 Fax:(360)398-2311 Site Maps Phone: (360)398-0134 Fax: 360 398-2311 `Yahoo! Maps,Driving Directions, and Traffic Page 1 of 1 IrA1-100,1! LOCAL Maps s aUi x Channel „ ; Ix a 9th St w. 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BOX 547 APPLIED: 05/07/93 ANACORTES, WA 98221 ISSUED: 05/07/93 (206) 293-1901 EXPIRES: 05/07/94 SITE ADDRESS: 1911 23RD ST ASSESSOR'S PARCEL NO. : 3798-000-073-0002 i PROJECT DESCRIPTION: Reroof — OWNER — CONTRACTOR — LENDER PRUDENTIAL SOUTHSIDE ESARY ROOFING 8 SIDING 2918 COMMERCIAL 420 PEASE ROAD ANACORTES WA 98221 BURLINGTON WA 98233 I, 293-9476 757-0933 ESARY*RS175KE TYPE OF WORK *REP AREA (sf) VALU. . . $: 2580 TYPE OF USE •SF LOT 0 REQUIRED SETBACKS---- CENSUS CATEGORY •434 1ST FLR 0 FRONT 0 ft ZONING 2ND FLR 0 SIDE ▪ 0 ft I :RL BASEMENT 0 REAR ▪ 0 ft OCCUPANCY GROUP GAR/CARPORT. . . : 0 REQUIRED PARKING-- :R3 :7 :7 :7 OTHER 0 TOTAL • 0 TYPE OF CONSTRUCTION HANDICAPPED: 0 :5N : ? : ? : ? NUMBER OF UNITS • 0 COMPACT • 0 OCCUPANT LOAD STORIES • 0 IMPRV SURF. : 0 sf 0: 0: 0: 0: BUILDING HEIGHT. : 0 ft — FEES — NOTES Code Amount---- By- Date---- Receipt PRMT $ 38.50 MD 05/07/93 1158 STBC $ 4.50 MD 05/07/93 1158 TOTAL $ 43. 00 I hereby acknowledge that I have read this permit and state that the above information is correct, and agree to comply with all ordinances and laws regulating activities covered by this permit. ( 117 .0. .( Q DW Issued by Applicant or Owner' s Signature 24 Hour Notice Required For All Inspections bld prmt, Rev: 06/11/92 ADDRESS 19 / f 03& LEGAL DESCRIPTION ASSESSORS ACCOUNT NO. PERMIT NO. DATE DESCRIPTION DATE FINALED 1 ( 31 i,