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* SAN JOIN COUNTY PUBLIC HEALTH I&VICES <br /> 304 E.WEBER AVE.,THIRD FLOOR • STOCKTON,CA 95202 • PHONE(209)468-3420 <br /> KAREN FURST, M.D., M.P.H., HEALTH OFFICER <br /> DONNA HERAN, R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> Program Permit Permit <br /> Record D) Number Program Code and Description Valid <br /> PRO514283 PT0010486 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1101 To 12131/01 <br /> Hazardous Waste Generator Program: <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.20_ _ ___ ___ <br /> PR0231465 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/01 To 12131/01 <br /> Underground Storage Tank Program: <br /> California Health and Safety Code Div,20,Chap_6.7 and Title 23 Califomia Code of Regulations Chap_16_______________ <br /> P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection <br /> 2360 6 390002314650146506 PT0004485 8,000 PREMIUM UNLEADED Active DOUBLE WALLED INTERSTITAL MONITOR <br /> 2360 5 390002314650146505 PT0004483 10,000 PREMIUM UNLEADED Active DOUBLE WALLED INTERSTITAL MONITOR <br /> 2362 4 390002314650146504 PT0004473 12,000 REGULAR UNLEADED Active DOUBLEWALLED AUTOMATIC TANK GUAGE <br /> ww <br /> Underground Storage Tank Permit Conditions <br /> I The Perrdt 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 <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 OCR,Title 23,Chap.16 and 18,as well as <br /> any conditions established by San Joaquin County. <br /> 3) If the Tank Operatur(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,die Permittee shall <br /> ensure that both the Tank Owner and tank Operator receive a copy of the permit. <br /> 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Environmental Health Division(PHS/F.HD)and are considerer)UST Permit <br /> Conditions. Copies of the Procedures and Emergency Response Plan most be attached to this permit or be available for review and/or inspection at the UST site <br /> 5) The Permittee shall comply with the monitoring procedures referenced in this permit. <br /> 6) The Per ounce shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or mon:frequently if specified by the equipment <br /> manufacturer,and provide documentation ofsuch servicing to this office. <br /> 7) In the event of a spill, leak,or other unauthorized release,the Permilee shall comply with the requirements of Title 23 CCR,Chap. 16,Art.5,and the approved Emergency <br /> Response Plan. <br /> 8) Written records of all monitoring performed shall be maintained on-site by the operator and be avaibble for inspection fora period of at least three years from the date the <br /> monitoring was performed. <br /> 9) The PHS/EHD 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 ofthe UST system(including change in tank contents or usage),the Permit to Operate will be subject to review, <br /> modification or revocation. <br /> 11) 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 Pernuttee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the anniversary date of the issuance ofthis 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: TIME OIL CO <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 95366 Issued 3/29/2001 <br /> Billing Address: ATTN : JOYCE MAUND <br /> TIME OIL CO <br /> 2737 W COMMODORE WAY <br /> SEATTLE, WA 98199-1233 <br /> 7023.rpt <br />