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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E.Weber Ave.,Third Floor•Stockton,CA 95202-2708• Phone(209)468-3420 <br /> Donna Heran, R.EH.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> Permit <br /> Program Permit Program Code and Description Valid <br /> Record ID Number p <br /> PR0513780 PT0009975 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY <br /> 71112003 To 72731/2003 <br /> Hazardous Waste Generator Program: <br /> California111200 0 ia Health and Safety Code,Div_20,Chap.6S,Art_2-13,Sec.25100 et so and Title 22,California Code of Re to Chap:20=-3 T 1213112003 <br /> PR0231631 2300-UNDERGROUND STORAGE TANK FACILITY <br /> Underground Storage Tank Program: <br /> Califomia Health and Safety Cale,Dty.20:Cho .6.7 and TiOa 23,-Califomia Code of Regulations,Chap._16. .--__----_--_.__.__..................._.--------------- <br /> Type <br /> tion <br /> P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status WUBIIE WA ED Continuwas InDlerstCal Mamlaln9 <br /> 2360 6 390002316310163106 PT0004143 8.000 PREMIUM UNLEADED Active,billable <br /> MIDGRADE UNLEADED ADtiva,billable DOUBLE WALLED Continuous Interstitial Monitoring <br /> 2360 5 390002316310163105 PT004142 10,000 REGULAR UNLEADED Active,billable DOUBLE WALLED Continuous interstitial monitoring <br /> 2362 4 390002316310163104 PTO004141 12,000 <br /> Underground Storage Tank Permit Conditions <br /> 1) The Permit to Operate will become void if Annual Permit Fees and Service Fees are not paid and/or the UST systems)(ails to remain in compliance with these Permit Conditions. <br /> 2) In order to maintain the operating pernL 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 I a,as well as any conditions <br /> established by San Joaquin County. the Permitlee shall ensure that both <br /> 3) If the Tank Operators)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 lank, <br /> the Tank Owner and tank Operator receive a copy of the permit <br /> 4) written Monitoring Procedures and an Emergency Response Pian most be approved by the Environmental Health Department(EHD)and are considererd UST Permit Comdidons. The approve <br /> monitoring,response,and plot plans shall be maintained onsite with the permit. <br /> 5) The Perntlee shall comply with the monitoring procedures referenced in this permit <br /> 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 <br /> Provide documentation of suchservicing to this office. <br /> 7) In the event of a spill,leak,or other unauthorized release,the Permitee shall comply with the requirements of Title io CCR,Chap.16,An.least <br /> and the approved Emergency Response Plan. <br /> g) written records of all monitoring performed shall be maintained on-site by the operator and be available for inspection for a period of al least three years from the dale the monitoring was <br /> performed. <br /> 9) The EHD shall be notified or any change in ownership or operation of die UST system within 3o days orsuch 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 /> 11) L9W&?5LRlbn,repair and(or removal permits are required from the ERD prior to any change,repair or removal of UST system equipment. <br /> 12) The Permittee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the anniversary dale of the issuance of this permit. <br /> 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. <br /> 14) A"Conditional"Permit maybe revoked ifcorections specified on the inspection report are not completed by the dam(s) indicated. <br /> ian <br /> RMITS TO OPERATE are NOTTRANSFERABLE <br /> for c <br /> d may be SUSPENDED or REVOKED ause. <br /> PERMIT(s)Valid only for: TIME OIL CO <br /> DBA: JACKPOT FOOD MART(LOCKEFORD) <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facilily ID FA0000091 <br /> Regulated Facility'. JACKPOT FOOD MART' Account ID AR0000090 <br /> 14000 E HWY 88 Issued 51112003 <br /> LOCKEFORD, CA 95237 <br /> Billing Address: <br /> JACKPOT FOOD MART* <br /> 2737 W COMMODORE WAY <br /> SEATTLE, WA 98199 <br /> 7020 rpt <br />