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�¢ SAN•4IN COUNTY PUBLIC HEALOIDVICES 304 E.WEBER AVE., BIRD FLOOR • STOCKTON,CA 95202 • PHONE (209) 468-3420 KAREN FURST, M.D., M.P.H., HEALTH OFFICER DONNA HERAN,R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION - ENVIRONMENTAL HEALTH COPY SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE ermrt rogram eProgram Code and Description Valid Record ID Number 8 P PR051378 P70009975 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY - 111100 To 12/31100 Hazardous Waste Generator Program: California Health and Safety Code Div.20,Chap.6.5,Art.2-13 Sec.25100 at seq,and Title 22 California Code of Regulations,Chap.20. _ 0A6i3163 2300 OU -UNDERGROUND STORAGE TANK FACILITY -- 111!00 To 12131100 Underground Storage Tank Program: California Health and Safety Code Div.20,Chap.6.7 and Title 23 California Code of Regulations Cha 16. ____ __ _ _ _ __ __ 9 p ----- ---- -- - - ---anM -ecor -11) - --- - ermi -- --apaciy on en _ __ _n_ ertni au ve 2360 5 390002316310163105 PT0004142 10,000 UNLEADED Active 2360 4 390002316310163104 PT0004141 12,000 UNLEADED Active - BOE 14379 :ffl 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 operatingPermit,the permit holder shall comply with the H&S Code,Div.20,Chap. 6.7 and 6.75;and CCR,Title23,Chap. 16 and 18,as well as any conditions established by San Joaquin County. 3) If the Tank 0erator(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 receives cpopy of the permit. ererd 4) UST Permit Conditions. Copies ofthe PmcProcedures and an edures andponse Emerga Emergency Resan tbe ponse Plan mosoved t beeatFached to thispermitorbe available orrrevrew and/or inand are spection 5) �he�er dt UST site. minee shall comply with the monitoring procedures refertenced 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 Pennitee 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 PHSIEHD 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 revocation. 11) Construction,repair and/or removal permits are required from the PHS/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 ofthe 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 corrections specified on the inspection report are not completed by the date(s) indicated. r PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: TIME OIL CO THIS FORST MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Facility ID FA0000091 Regulated Facility: JACKPOT FOOD MART' Account ID AR0000090 14000 E HWY 88 Issued 9128/2000 LOCKEFORD, CA 95237 Billing Address: JACKPOT FOOD MART' PO BOX 24447 TERMINAL ST SEATTLE,WA 98124-2447 7023.rpt