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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 304 E.Weber Ave.,Third Floor• Stadcton, CA 95202-2708• Phone(209)468-3420
<br /> Donna Heron, REH.S.,Director
<br /> ENVIRONMENTAL HEALTH
<br /> SAN JOAQUIN COUNTY CERTIFIED LNIFIED PROGRAM AGENCY
<br /> PERMIT TO OPERATE
<br /> Program Permit Permit
<br /> Record ID Number Program Code and Description Valid
<br /> PRO514283 PT0010486 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/2004 To 12/3172004
<br /> Hazardous Waste Generator Program:
<br /> In order to maintain the permit to operate,Hazardous Waste Generators shall comply With California Health and Safety Code,Div.20,Chap.6.5,Art.2-13,
<br /> Sec,25100 et secs,and Title 22,California Code of Regulations,Chap.20, _ ---
<br /> de
<br /> PR0231465 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/2004 To 12/31/2004
<br /> Underground Storage Tank Program:
<br /> California Health and Safety Code,Div.20,Cha--------------------------------.6.7 and Title 23,California Code of Regulations,Chap:16. .............._
<br /> ---- ------- -------- ------------- ' ' - - ---------- ' - ---------------------------------------
<br /> P/E Tank# Tank Record ID Permit# Capacity Con=iLi Permit Status System Type Leak Detection
<br /> 2360 6 390002314650146506 PT0004485 8,000 PREMIUM LNLEADED Active,billable DOUBLE WALLED continuous Interstitial Mmulccri;
<br /> 2360 5 390002314650146505 PT0004483 10,000 MIDGRADE LNLEADED Active,billable DOUBLE WALLED Continuous Interstitial Morritc,i i
<br /> 2362 4 390002314650146504 PT0004473 12,000 REGULAR LNLEADED Active,billable DOUBLE WALLED Continuous Interstitial Mortltmrc
<br /> BOE ID#,. 44-014379
<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 ardor the CST system(s)fails to remain in compliance with these Permit Conditions.
<br /> 2) In order to maintain the operating pen-nit,the owner and operator shall comply with the H&S Cc-2e.Dir'.''-0,Chap.6.7 and 6.75;and CCR.Title 23,Chap.16 and 19,as well as any conditions
<br /> established by San Joaquin County.
<br /> 3) If the Tank Operator(s)is diflerent from the Tank Owner,or i f the Permit to Operate is issued to a person other than the owner or operator of the tank.the Permittee shall ensure that both
<br /> the Tank Owner and tank Operator receive a copy of the permit.
<br /> 4) Written Monitoring Procedures and an Emergency Response Plan most be approved by the Emrm maul Health Department(EHD)and are considererd UST Perrnit 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 testing and preventive maintenance on all leak detection monis .ng equipment annually,or more frequently ifspecified 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 Permitee shall comply with the mquimments of Title 23 CCR Chap.16.An.5,and the approved Emergency Response Plate
<br /> S) 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 EHD shall he notified of any change in ownership or operation of the UST system within 30 da7s of such change.
<br /> 10) Upon any change in equipment,design or operation of the UST system(including change in ink contents or usage),the Permit to Operate will be subject to review,modification or
<br /> 11) L9&%1&141bn,repair and/or ren ewid pemtits are required from the EHD prior to any change,rep=or removal of UST system equipment
<br /> 12) The Pemrime shall submit an annual report documenting compliance with the UST Permit Cordons within 30 days of the date of the issuance of this permit
<br /> 13) This Permit to Operate shall not be considered permission to violate any laws,ordinances or;mtutzs of any other Federal,State or Local agency.
<br /> 14) A"Conditional'Permit may be revoked ifcorrecrions specified on the inspection report are nor completed by the date(s) indicated
<br /> PERMITS TO OPERATE we NOT TRANSFERABLE
<br /> and may be SUSPENDED or REVOKED for cause.
<br /> PERMIT(s)Valid only for: TIME OIL CO
<br /> DBA: JACKPOT FOOD MART (MNTCA)
<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> Regulated Facility: JACKPOT FOOD MART* Facility ID FA0003739
<br /> 1434 W YOSEMITE AVE Account ID AR0008444
<br /> MANTECA, CA 95336 Issued 4/112004
<br /> Billing Address:
<br /> JACKPOT FOOD MART*
<br /> 2737 W COMMODORE WAY
<br /> SEATTLE, WA 98199
<br /> 7023.rpt
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