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i • SAN JOAQUIN COUNTY ENVHtONMENTAL HEALTH DEPARTMENT 1868 E. Hazelton Ave. • Stockton, CA 95205-6232 a Phone (209) 468-3420 Donna Heran, R.E.H.S., Director ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE Program Co Permit Permit Record ID umber Program de and Description Valid PRO527197 P100`19015 2220 -SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 111/2013 To 12/311/2013 Hazardous Waste Generator program In order to maintai i the permit to operate, Hazardous Waste Generators shall comply with California Health and Safety Code, Div. 20, Chap. 6.5, Art. 2-13, Sec. 25100 at se and Title 22, California Code of Regulations, Chap. 20,_-------_------__-------___-----__------------------_-------__---------..-_---__.-----.... ----------------- --- - --------- - - - PR0524617 2300 - UNDERGROUND STORAGE TANK FACILITY 1/1/2013 To 12/3112013 Underground Stor toe Tank Program California Healthnd Safety Code, Div. 20, Chap. 6.7 and Title 23, California Code of Regulations, Chap_ 16. __------------------__---------------------.------. 2350 2 90005246170515788 PT0016812 12,000 PREMIUM UNLEADED Active, billable DOUBLE-WALL Continuous Interstitial Monitoring 2350 3 90005246170515789 PT0016814 10,000 DIESEL Active, billable DOUBLE-WALL Continuous Interstitial Monitoring BOE ID#: -440411l69 Un dergro u n I Storage Tan k Permit Conditions - 1) The Permit to C iterate 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. 2) In order to main m the operating permit, the owner and operator shall comply with the H&S Code, Div. 20, Chap. 6.7 and 6.75; and CCR, Title 23, Chap. 16 and 18, as well as any conditions established by S in Joaquin County. - - 3) If the Tank Op Ior(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 both the Tank Owne and tank Operator receive a copy of the permit. 4) Written Mardian ng Procedures and an Emergency Response Plan must be approved by the Environmental Health Department (EHD) and arc considererd UST Permit Conditions. The approved monitoring, map me, and plot plans shall be maintained onsite with the pemdt. 5) The Permittee s all comply with the monitoring procedures referenced in this permit. 6) The Permittee a tall perform testing and preventive maintenance on all leak detection monitoring equipment annually, or more frequently if specified by the equipment manufacturer, and provide doeum oration ofsuch servicing to this office. 7) In the event of i 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 Plan. 8) 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 was performed 9) The EHD shall I a notified of any change in ownership or operation of the UST system within 30 days of such change. 10) Upon any chiml re in equipment, design or operation of the UST system (including change in tank contents or usage), the Permit to Operate will be subject in review, modification or revocation. 11) Construction, air and/or removal permits are required from the EHD prior to any change, repair or removal of UST system equipment. 12) This Permit to perate shall not be considered permission to violate any laws, ordinances or statutes of any other Federal, State or Local agency. 13) A "Conditional Permit maybe revoked if corrections specified on the inspection report are not completed by the date(s) indicated. , PERMITS TO OPERATE may be SUSPENDED or REVOKED for cause. PERMIT(s) Valid only for: RALEYS DBA: RALEY'S Tank Owner: RALEYS FAMILY OF FINE STORES THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES RALEYS FUEL STATION #356 Facility ID FA0016523 Regulated Facili 4219 E MORADA LN Account ID AR0029109 STOCKTON CA 95212 issued 2/1912013 Billing Address ATTN : RALEY'S RALEYS FUEL STATION #356 500 W CAPITOL AVE SACRAMENTO CA 95605 7023.mt