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Napo, .o SAN JOAQUIN COUNTY ENVIRONMENTAL.HEALTH DEPARTMENT P F •I 304 E.Weber Ave.,Third Floor• Stockton,CA 95202-2708 at Phone(209)468-3420 Donna Heran,REH.S.,Director ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE Permit Program Permit Record ID Number Program Code and Description Valid PRO514003 PT0010198 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 11112004 To 12/31/2004 Hazardous Waste Generator Program: In order to maintain 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 et seq,_and TiOe 22,Califomia Code of Regula0ons,Chap,20._--__-----_-_-_______...._..................__... ..__.....--.__...-------.--.------------------ PR0231036 2300-UNDERGROUND STORAGE TANK FACILITY 11112004 To 1213112004 Underground Storage Tank Program: California Health and Safety Code, Div_20.Chap.6.7 and Title 23,California Code of Regulations,Chap_16. ..................____________.---___._ P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection 2362 3 390002310360103603 PT0004627 20,000 DIESEL Active,billable DOUBLE WALLED Canorous interstitial Monitoring 8051D#., 44-024500.'-' Underground Storage Tank Pertttit Conditions 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. 2) in order to mwinuin the operating permit,the owner and operator shall comply with the H&S Cade,Div.20,Chap.6.7 and 6.75;and CCR,Tide 23,Chap.16 and 19,as well as any conditions established by San Joaquin County. 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 both the Tank Owner and tank Operator receive a copy of the permit. 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Emironmental Health Department(EHD)and are considererd LST Permit Conditions. The approved monitoring,response,and plot plans shall be maintained otsite with the permit. 5) The Pemdmee shall comply with the monitoring procedures referenced in this permit. 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,and provide documentation of such servicing to this office. 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,Am 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 fora period of at least three years from the date the monitoring was performed. 9) The EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change. 10) Upon any change in equipment,design or operation of the UST system(including change in unit contents or usage),the Permit to Operate will be subject W review,modification or 11) LSYfd9I1416,repair and/or removal permits are required from the EHD prior W any change,repair or removal of CST system equipment. 12) The Pemdttee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the date of the issuance of this pemde 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. 14) A"Conditional"Permit maybe revoked if corrections specified on the inspection report are not completed by the date(s) indicated. PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: ST JOSEPHS REGIONAL HOUSING CO DBA: ST JOSEPHS REGINAL HOUSING Tank Owner: ST JOSEPHS MEDICAL CENTER CORP THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Regulated Facility. ST JOSEPHS HOSPITAL F-Idy ID FA0003761 1800 N CALIFORNIA ST Account ID AR0003340 STOCKTON, CA 95204 Issued 4/1/2004 Billing Address: ATTN : ATTN: STEVE THOMPSON ST JOSEPHS HOSPITAL PO BOX 213008 STOCKTON, CA 95213-9008 7023 rpt