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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E. Weber Ave., Third Floor • Stockton, CA 95202-2708 • Phone (209) 468-3420 Donna Hcran, R.E.H.S., Director ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE Program Permit Permit Record ID Number Program Code and Description Valid PRO514045 PT0010240 2220 - SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/2003 To 12/31/2003 Hazardous Waste Generator Program: California Health and Safety Code, Div_ 20, Chap. 6:5, Art_ 2-13, Sec_ 25100 et seq, and Title 22, California Code of Regulations, Chap. 20_ ------ -------------------- ---- PR0231070 2300 - UNDERGROUND STORAGE TANK FACILITY 1/1/2003 To 12/31/2003 Underground Storage Tank Program: California Health and SafetCode, Div. 20, Chap. 6.7 and Title 23, California Code of Regulations, Chap_ 16. ------------------------------------------ _----- ----------- - ----------------------------------- P/E Tank # Tank Record 1D Permit # Capacity Contents Permit Status System Type Leak Detection 2360 7 390002310700505600 PT0008167 15,000 REGULAR UNLEADED Active, billable DOUBLE WALLED Continuous Interstitial Monitoring 2360 8 390002310700505601 PT0008166 15,000 PREMIUM UNLEADED Active, billable DOUBLE WALLED Continuous Interstitial Moniwng 2362 5 390002310700107005 PT0004847 550 OTHER Active, billable DOUBLE WALLED Continuous Interstitial Monitoring B0.E"s.WV4-42�Wa?y`i 1"! Underground Storage Tank Permit 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 maintain the operating pcmiiL 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 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 Environmental Health Department (EHD) and are considererd UST Permit Conditions. The approved monitoring, response, and plot plans shall be maintained onsite with the permit. 5) The Permittee 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 Permitec 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 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 tank contents or usage), the Permit to Operate will be subject to review, modification or 1 1) M91AL91bn, repair and/or removal permits are required from the EHD prior to any change, repair or removal of UST system equipment. 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. 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 may be revoked if corcctions 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: SHELL OIL PRODUCTS US Tank Owner: SHELL OIL COMPANY THIS FORM NIUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Regulated Facility: COUNTRY CLUB SHELL* Facility ID FA0006439 2575 COUNTRY CLUB BLVD Account ID AR0008426 STOCKTON, CA 95204 Issued 5/1/2003 Billing Address: COUNTRY CLUB SHELL* 2575 COUNTRY CLUB BLVD STOCKTON, CA 95204 7023 rpt