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`1 <br /> SAN JOAN COUNTY PUBLIC HEALTH SERICES <br /> 304 E.WEBER AVE.,THIRD FLOOR • STOCKTON,CA 95202 a PHONE(209)468-3420 <br /> KAREN FURST.M.D.,M.P.H., HEALTH OFFICER <br /> DONNA HERRN,R.E.H.S.,DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTYCERTIFIED <br /> RTIFI DOFERATINE PROGRAM AGENCY <br /> Pemrit <br /> Valid <br /> 7:Td!) <br /> at pmgam Code and Desaiptian 111101 To 12131101 <br /> 220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY <br /> 4210 PT00 - .dous Waste Gene o ram: 111101 To 12131101 <br /> 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._ _____________ <br /> ---" 2300-UNDERGROUND STORAGE TANK FACILITY <br /> PR023249 _ <br /> Under r t e Tank Pro ram: <br /> Safe Code Div,20,Chap,6.7 and Title 23 California Code of R_egulations Chap_1- ---------------- ----------" --" <br /> tUndergroundStorape <br /> rm _ __-tY- Contenu Permit Status <br /> Tank k Record ID Permit# Capacity Active <br /> 1 0002324940249401 PT0004562 12,000 <br /> UNLEADED <br /> Tank Permit Conditions <br /> 1) The Permit to Operate will become void if Anmual Permit Fees and Service Fees are not paid and/or the UST system(s)fails to remain in compliance with these Permit <br /> ,as well as <br /> Conditions. <br /> 2) In order to maintain the operating permit,the permit holder shall comply with the H&S Code,Div.20,Chap.6.7 and 6.75;and CCR,Titleon of t Chap.16 <br /> e Permittee hall <br /> any conditions 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, <br /> ensure that both the Tank Owner and tank Operator receive a copy of the permit. <br /> 4) CoThen nditions nCoringpies of Ihedurec and a and Emergencyzmergency sResponse Plmt must beponse Plan must be pattached to this roved by the vperrrut orlbe available for review andlo�r inspection at the sS�Permd <br /> 5) The Permittee shall comply with the monitoring procedures referrenced in this permit. or more frequently if specified by the equipment <br /> 6) The permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment an <br /> manufacturer,and provide documentation of such servicing to this office. rements of Title 23 CCR,Chap. <br /> 7) In the event of a spill,leak,or other unauthorized release,the PermiLe shall comply with the recital <br /> 16,Art.5,and the approve Emergency <br /> Reponse Plan. <br /> g) Written records of all monitoring performed shall be maintained on-site bythe opemtorand be avaiable for inspection fora period of at least three years from the date e <br /> monitoring was performed. <br /> 9) The PHS/EHD shall be notified of any change in ownership a operation of the UST system within 30 days of such change. <br /> Ill) Upon any change in equipment,design or operation ofthe UST system(including change in tank contents or usage),the permit to Operate will be subject to review, <br /> modification or revocation. <br /> l l) Construction,repair and/or removal permits are required from the PHS/EHD 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 date ofthe 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 may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: KAISER PERMANENTE <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facility ID FA0002602 <br /> Regulated Facility: KAISER PERMANENTE Account ID AR0004672 <br /> 7373 WEST LN Issued 3129/2001 <br /> STOCKTON. CA 95210 <br /> Billing Address: ATTN : KAISER PERMANENTE <br /> KAISER PERMANENTE <br /> 7373 WEST LN <br /> STOCKTON, CA 95210 <br /> 7023.rpt <br />