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SAN JOAQUIN COUNTY ENVIRONMENTAL HBALTH DEPARTNINT"
<br /> 304 E-Wei Ave.,Third Floor*Smdcton,CA 95202-2708* Phone(209)468-3420
<br /> Donna Heran;.R.E.KS.,DirecYot
<br /> ENVIRONMENTAL HEALTH
<br /> SAN JOAQUIN.COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br /> PERMIT TO OPERATE
<br /> Program Permit Permit
<br /> Record ID Number Program Code and Description Valid
<br /> PR0618923 PT0012257 2230-SMALL QUANTITY HA7ARb0U9 WASTE GENERATOR FACILITY1//12006 12131/2006
<br /> Hazardous Waste Generator Program:
<br /> In order to maintain the permitto operate, Hazardous Waste Generators shall comply with California.Health,and Safety Code;Div.20,Chap.6.5,Art.2-13,
<br /> Sec,-25190 seg;_and Title 22,California-Code of Regulations,Chap.20,. _ _ _
<br /> PRO516736 2300-UNDERGROUND STORAGE TANK FACILITY - 1/1/2006 To 12/31/2006
<br /> Underground.Storage:Tank Program:
<br /> California Health and Safety_Code:Div-20,Chap.6.7 Title 23,Callfornia_Code-of Regulations,.Chap, 16. ___, _
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<br /> I PIE Tank#. Tank Record) D Permit# Capacity Contents Permit Status System Type - Leak Qcte7F
<br /> 2362 1 390005167360515557 PT0011472 20,000 REG LAR.UNLEADED Active, billable DOUBLEWALLED Coinnuogs interstitial Monitoring
<br /> 2360. 2 390005167360515558 PT0011473 10,000 REGULAR UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial Monitoring
<br /> 2360- 3 390005167360515559 PT0011474 10,000" REGULAR UNLEADED.. Active,billable DOUBLE WALLED Continuous:Interstitial Monitoring
<br /> Underground Storage Tank Permit Conditions.
<br /> I The Permit toOperatewill become void if Annual Permit Fees and Service Fees are not paid scatter the UST system(s)fails to remain in eomphancewith these Permit Conditions
<br /> 2) N ordeclo maintain the operating peanut,the owner and operator shall comply with the H@S Code,Div.20,Chap.6.7 and 6.75;.and CCR;Tide 23,Chap.16 and 18,w well as any conditions.
<br /> 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 both
<br /> the Tank Owner and tank Operator receive a copy of the permit.
<br /> 4) Written Monitoring Procedures and an Emergency Response Plan most be approved by the Environmental Health Department(EHD):and are coMi*mrd UST Permit Conditions. The approved
<br /> monitoring,response,and plot plans shall be maintained onsite withria;permit -
<br /> 5). The Perrwttee shall comply with the monitoring procedures referenced in this per h,
<br /> 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently if specified bythe equipmentmanufacturer,and
<br /> provide documentation of such aervicing.tuthis office.
<br /> 7) In the event of a spill,Irak,or other unauthorized release,.the Perenhee shall comply with the requirements of Title 23 CCR,Chap.16,ArL 5;and the approved Emergency Response Plan.
<br /> 8) Written recordsof all:monitoring performed shall be maintained'orrsite by the uperatorandbe available for inspection for a period of at least three years from the date the monitoring was
<br /> performed
<br /> 9) The EHD shall be entified of any change in ownership or operation of the UST system within 30 days ofsuch change -
<br /> ,10) Uponmy 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,modificatidn or
<br /> revocation.
<br /> 11) Construction,repair and/or removal permits are required from.the EHD prior Way change,repair or removal of UST system equipment -
<br /> 12) The Permittee shall submit an annual report documenting compliance with the UST Ptrnit Conditions within 30 days of the date ofthe issuance of this permit
<br /> 13) This.Permit to Operate shall not be considered permission to violate any laws,ordinances drstatutes of any other Federal,State or Local agency.
<br /> 14) A"Conditional"Permit may be revoked if eprections specified on the inspection report are not completed by the dates)indicated.
<br /> PERMITS TO OPERATE are NOT TRANSFERABLE
<br /> and may be SUSPENDED or REVOKED for cause.
<br /> FERMIT(s)Valid only for: DENNIS JACOBSEN'FAMILY HOLDING
<br /> DBA: SAFEWAY STORE#1769
<br /> Tank Owner: SAFEWAY FUEL CENTER#1769
<br /> THISFORMMUST BE DISPLAYED CONSPICUOUSLY ON.THE PREMISES-
<br /> Regulated Facility SAFEWAY FUEL CENTER#1769 Facilityll FA0012764
<br /> 2808 COUNTRY CLUB BLVD A=unt ID;AR0021335
<br /> STOCKTON CA 95204 lssued 211/2006
<br /> Billing Address: ATTN C/0. DAIGNEAU, EMILY -
<br /> SAFEWAY FUEL CENTER #1169 .
<br /> 12265 W BAYAUD AVE, .BTE -30.0
<br /> LAKEWOOD CO 8.0228
<br /> <7023.ipt ..
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