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• f <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E.Weber Ave.,Third Floor•Soockton,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 /> Program Permit I'cnnit <br /> Record ID Number Program Code and Description <br /> Valid <br /> PRO514283 PT0010486 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/2003 To 12/31/2003 <br /> Hazardous Waste Generator Pro-gram, <br /> Califomla Health and Safety Code,Div.20,Chap.6St Art.2-13,Sec_25100 at seq,and Title 22,California Code of Regulations:Chap_20_ <br /> ------ - --- ----- -' '---- '.' ".-' ---- ........ ---------.. <br /> PR0231465 2300-UNDERGROUND STORAGE TANK FACILITY 111/2003 To 1213112003 <br /> Underground Storage Tank Program, <br /> CaliforniaHealth and Safe Code,Div.20,Cha 6.7 and Title 23,California Code of Regulations,Chap:16. <br /> --- ----- - - ..y -- ...P... . <br /> P/E Tank# Tank Record ID Penni!# Capacity Contents Permit Status System Type Leak Detection <br /> 2360 6 390002314650146506 PT0004485 8,000 PREMIUM UNLEADED Active,billable DOUBLE WALLED comtoums interstitial venmoring <br /> 2360 5 390002314650146505 PT0004483 10,000 MIDGRADE UNLEADED Active,billable DOUBLE WALLED continuous Interstitial Monitoring <br /> 2362 4 390002314650146504 PT0004473 12.000 REGULAR UNLEADED Active,billable DOUBLE WALLED Continuous Interstival Monitoring <br /> 130121 O 5"gfid37?j <br /> Underground Storage Tank Permit Conditions <br /> 1) The Permit to Operate will become void if Annual Permit Fees and Service Fees arc not paid and/or the UST system(s)fails to remain in compliance with these Permit Conditions. <br /> 2) In order to maintain the operating permit,the owner and operator shall comply with the H&S Code,Div.20,Chap.6.1 and 6.75;and CCR,Title 23,Chap.16 and 18,as well as any conditions <br /> established by San Joaquin County. <br /> 3) If the Tank Operaturls)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,the Perniltee shall ensure that both <br /> the Tank Owner and lank Operator receive a copy of the permit. <br /> 4) Written Monitoring Procedures and an Emergency Response Plan most be approved by the Environmental Health Department(Ef1D)and are considererd UST Permit 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 monitoring equipment annually,or more frequently if specified by the equipment manufacturer,and <br /> provide documentation of such servicing to this office. <br /> 7) In the event of spill,leak,or other unauthorized release,the Permit"shall comply with the requirements of Title 23 CCR,Chap.16,Art 5,and the approved Emergency Response Plan. <br /> 8) Written records of all monitoring performed shall be maintained on-site by the operator and he available for inspection for a period of at least three years from the date the monitoring was <br /> performed. <br /> 9) The E14D shall be notified of any change in ownership or operation of the UST system within 30 days of such change. <br /> 10) Upon any change in equipment,design or operation of the UST system(including change in lank contents or usage).the Permit to Operate will be subject to review,modification or <br /> 11) ffVA9k4fbn,repair and/or removal permits are required from the 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 Condi lions 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,Stale or Local agency. <br /> 14) A"Conditional"Permit maybe revoked if corrections specified on the inspection report are not completed by the dale(s) indicated. <br /> PERMITS TO OPERATE are 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 fD FA0003739 <br /> 1434 W YOSEMITE AVE Account lD AR0008444 <br /> MANTECA, CA 95366 Issued 5/1/2003 <br /> Billing Address: <br /> JACKPOT FOOD MART* <br /> 2737 W COMMODORE WAY <br /> SEATTLE, WA 98199 <br /> 7023.rpt I <br />