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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />304 E. Weber Ave., Third Floor • StorJaon, CA 95202-2708 • Phone (209) 468-3420 <br />Donna Henan, R.EH.S., Director <br />ENVIRONMENTAL HEALTH <br />SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br />PERMIT TO OPERATE <br />Program Permit Permit <br />Record ED Number Program Code and Description Valid <br />PR023148 2300 - UNDERGROUND STORAGE TANK FACILITY 1/1/2002 To 12/31/2002 <br />Underground Storage Tank Program: <br />------------------- <br />P/E <br />Tank# <br />---------------------------------- <br />Tank Record ID <br />----------------------------------------------------------------_.------ <br />Permit# <br />Capacity <br />Contents <br />Permit Status <br />System Type <br />- - ------------------ <br />2360 <br />6 <br />390002314820504846 <br />PT0007198 <br />2,632 <br />DIESEL <br />Active, billable <br />DOUBLE WALLED <br />Continuous Interstitial <br />Monitonng <br />2360 <br />5 <br />390002314820504845 <br />PT0007197 <br />6,768 <br />REGULAR UNLEADED <br />Active, billable <br />DOUBLE WALLED <br />Continuous Interstitial <br />Monitonng <br />2362 <br />4 <br />390002314820504844 <br />PT0007196 <br />2,632 <br />REGULAR UNLEADED <br />Active, billable <br />DOUBLE WALLED <br />Continuous Interstitial <br />Monitonng <br />Underground Storage Tank Permit Conditions <br />1) The Permit to Operate will become void if Annual Permit Fees and Service Fees are not paid and/or the UST system(s) fails to remain in compliance with these Permit Conditions. <br />2) In order to maintain the operating permit, the owner and opcmmr shall comply with the H&S Code, Div. 20, Chap. 6.7 and 6.75; and CCR, Title 23, Chap. 16 and 19, as well as any <br />condifions established by San Joaquin County. <br />3) If the Tank Operator(s) is different from the Tank Owner, or if the Permit to Operate is issued to a person other than the owner or operator of the tank, the Permittee shall ensure that <br />both the Tank Owner and tank Operator receive a copy of the permit. <br />4) Written Monitoring Procedures and an Emergency Response Plan mmtbe approved by the Environmental Health Department (EHD) and are considererd UST Pemdt Conditions. The <br />approved monitoring, response, and plot plans shall be maintained onsite with the permit <br />5) The Pemdmee shall comply with the monitoring procedures referenced in this permit <br />6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually, or more frequently if specified by the equipment manufacturer, <br />and provide documentation of such servicing to this office. <br />7) In the event of a spill, leak, or other unauthorized release, the Permitee shall comply with the requirements of Title 23 CCR Chap. 16, Art. 5, and the approved Emergency Response <br />Plan. <br />S) Written records of all monitoring performed shall be maintained on-site by the operator and be available for inspection for a period of at least three years from the date the monitoring <br />was performed. <br />9) The EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change. <br />10) Upon any change in equipment, design or operation of the UST system (including change in tank contents or usage), the Permit to Operate will be subject to review, modification or <br />revocation. <br />11) Construction, repair and/or removal permits are required from the EHD prior to any change, repair or removal ofUST system equipment. <br />12) The Permittee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the anniversary date of the issuance of this permit <br />13) This Permit to Operate shall not be considered permission to violate any laws, ordinances or statutes of any other Federal, State or Local agency. <br />14) A "Conditional" Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. <br />PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />PERMIT(s) Valid only for: MADSEN, ROBERT & CAROL <br />DBA: MADSENS SUNRISE DAIRY <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMLSFS <br />Regulated Facility: MADSEN'S SUNRISE DAIRY <br />239 S STOCKTON ST <br />RIPON. CA 95366 <br />Billing Address: ATTN : MADSEN, ROBERT <br />MADSEN'S SUNRISE DAIRY <br />239 S STOCKTON <br />RIPON, CA 95366 <br />7023.rpt <br />Facility ID FA0000720 <br />Account ID AR0000719 <br />Issued 3/29/2002 <br />