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SAN JOAQUIN COUNTY ENVfRONMENTAL HEALTH DEPARTMENT
<br /> 1868 E. Hazelton Ave. It, Stockton,CA 95205-6232 • Phone(209) 468-3420
<br /> Donna Heran,R.E.H.S.,Director
<br /> ENVIRONMENTAL HEALTH
<br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br /> PERMIT TO OPERATE
<br /> Program Permit Permit
<br /> Record to Number 'ogre Code and Description Valid
<br /> 8259=--tP-TO - 20-m
<br /> A_tL$OANTtTY-HAZARDOUS WASTE-GENERATOR F_A_Cltt -- _- -- 111130t_3_ o=12I31t20t_3
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<br /> HazardoWase O92o M
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<br /> In
<br /> order to maintain the perm) operate,Hazardous Waste Generators shall comply with California Health and Safety Code,Div.20,Chap.6.5,Art.2-13,
<br /> Sec.25100 et seq and Title 22,California Code of Regulations,Chap.20_
<br /> PRO527629 2300-UNDERGROUND STORAGE TANK FACILITY 1/112013 To 12/3112013
<br /> Underground Storage Tank Program:
<br /> California Health and Safety Code,Div.20,Chap.6.7 and Title 23,California Code of Regulations,Chap_16.
<br /> - - - --------- - - "'- ----
<br /> P/E Tank# Tank Record ID Permit CapacityContents Permit Status System Type Leak De[echon
<br /> 2352 1 390005276290515840 PT0019359 30,000 REGULAR UNLEADED Active,billable DOUBLE-WALL Continuous Interstitial Monitoring
<br /> 2350 2 390005276290515841 PT0019360 30,000 REGULAR UNLEADED Active,billable DOUBLE-wALI Continuous Interstitial Monitoring
<br /> 2350 3 390005276290515842 PT0019361 30,000 PREMIUM UNLEADED Active,billable DOUBLE-WALL Continuous Interstitial Monitoring
<br /> BOE ID#: 44039100
<br /> Underground Storage Tank Permit Conditions
<br /> 1) The Permit to Operate will become void if Annual Persil 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 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
<br /> established by San Joaquin County.
<br /> 3) If the Tank Operaton(s)is different from the Tank Owner,or if the Permit to Operate is issued to a person otherthon the owner or operator of the tank,the Permittee shall ensure Thal both
<br /> the Tank Owner and tank Operator receive a copy of the permit.
<br /> 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
<br /> monitoring,response,and plot plans shall be maintained onsite with the permit.
<br /> 5) The Permittee shall comply with the monitoring procedures referenced in this permit,
<br /> 6) The Permittee shall perform testingand preventive maintenance on all leak detection monitoring equipment annually,or more frequently if specified by the equipment manufacturer,and
<br /> provide documentation of such servicing to this office.
<br /> 7) In the event of a spill,leak,or other unauthorized release,the Permilee shall comply with the requirements of Title 23 CCR,Chap, 16,Art.5,and the approved Emergency Response Plan.
<br /> 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
<br /> performed.
<br /> 9) The FRO 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 of UST system equipment.
<br /> 12) 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 /> 13) A"Conditional'Permit maybe revoked ifcomeclions specified on the inspection report are not completed by the date(s) indicated.
<br /> PERMITS TO OPERATE may be SUSPENDED or REVOKED for cause.
<br /> PERMIT(s)Valid only for: COSTCO WHOLESALE CORPORATION
<br /> DBA: COSTCO
<br /> Tank Owner: COSTCO WHOLESALE,ATTN: LICENSING
<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> COSTCO WHOLESALE#1031 Facility ID FA0018721
<br /> Regulated Facility: 2440 DANIELS ST Account ID AR0033237
<br /> MANTECA CA 95336 Issued 2/1912013
<br /> Billing Address. ATTN LICENSING DEPT
<br /> COSTCO WHOLESALE #1031
<br /> PO BOX 35005
<br /> SEATTLE WA 98124-3405
<br /> 7023.rpt
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