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w SAN JOAQ41IN COUNTY PUBLIC HEALTH SLOVICES 304 E.WEBER AVE.,THIRD FLOOR • STOCKTON,CA 95202 • PHONE(209)468-3420 KAREN FURST,M.D., M.P.H.,HEALTH OFFICER DONNA HERRN,R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE er at ogram errrut Valid Record ID Number Program Code and Description 111/00 To 12/31100 PR051421 P10010413 2220-SMALL ....IHAZARDOUS WASTE GENERATOR FACILITY 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_„1100 To 12131100 Ty PR023249 2300-UNDERGROUND STORAGE TANK FACILI Underground Storage Tank Program: .7 and Title 23 California Code of Regulations Chap. -- - -------- -- -- - -- - California Health and Safety Code Div.20,Chap.6an III[EMe 7:rve 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 systems)fails o remain in compliance with these Permit Conditions. 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,Tide 23,Chap. 16 an 18,as well as any conditions established by San Joaquin County. 3) IftheTank Operators)is different from the Tank Owner,or if the Permit to Operate is issued o a person other than the owner or operator of the tank,the Pernuttee shall ensure that both the Tank Owner and tank Operator receive a copy of the permit. and are considererd 4) UWritten ST Penn t ConduiProcedures and an ons. Copies of the Procedures and EmergeRes onse )an must be cy Response Plan musoved [be attached othe ethisitalpermit r bHealth e avaiable for review and/oinspection 5) �th UST site. IreePermttee shall comply with the monitoring procedures referenced in this permit. 6) The.Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently ifspecified 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 Pernitee shall comply with the requirements of Title 23 CCR,Chap. 16,Art.5,and the approved Emergency Response Plan. 8) crit theecords monof all itoring was performed er formed shall be maintained on-site by the operator and be available for inspection for a period ofat least three years 9) The PHS/EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change. 10) review,mchang i neo equipment, design or operation of the UST system(including change in tank contents or usage),the Permit to Operate will be subjectto 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 of the 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: KAISER PERMANENTE THIS FORM h1UST BE DISPLAYED CONSPICUOUSLY T THE PREMISES KAISER PERMANENTE Facility ID FA0002602 Regulated Facility: Account ID AR0004672 7373 WEST LN Issued 912812000 STOCKTON, CA 95210 Billing Address: ATTN : KAISER PERMANENTE KAISER PERMANENTE 7373 WEST LN STOCKTON, CA 95210 7023.rpt