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SAN JUIN COUNTY PUBLIC HEALTIWRVICES
<br />P O Box 3 • S OCKTON, CA 95201-0388 • pHONE (209) 468-3420
<br />ERNEST M. FUJIMOTO, M.D., M.P.H., ACTING HEALTH OFFICER
<br />DONNA HERRN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION
<br />ENVMONMENTAL HEALTH
<br />CPMATI PERMIT FOR e_ IIINEU?GROLit4D STORAGE TANK FAC Li i 3
<br />PERMIT CONDITIONS:
<br />:) The PERMIT T1 OPERATE will: become void if ANiv`LKk_ PERMIT Fees and SERVICE Fees are not paid andlrr the LIST sYstem(s) iai_s
<br />to remain in compliance with the PERMIT CONDITIONS.
<br />2) The PERMIT TI' OPERATE is granted t4a the TANK, O'WPER who accepts regporsibilif.v for operating and monitoring the I)OT systes,,
<br />according to State underground storage tank laws and regulations as well as any conditions established by :San Tcaquin, County.
<br />3:! The TANK OPERATOR(S), if different from the tank owner, shall operate and r,,nitor the UST system according to the WRI-TE'
<br />OPERATING AGREEMENT required under Section 25233, Chapter 6.7, Division 20, California 'Health and Safety CNie.
<br />4` The TANK OWNEP shall notify the Environmental Healt:, Division of any Proposed change in operation or ownership of the UST
<br />system.
<br />S) t!pon any change in equipment, design or operation of this facility, tte PER TO OPERATE will be reviewed by the
<br />Environmental Health Division.
<br />6) A construction, or removal permlt is requires; from the Environmental Health Division Prior to any removal or
<br />change of UST system equipment.
<br />Ti This PERMIT TO OPERATE shall not be considered Permission to violate any e=.icting laws, ordinances or statutes of other
<br />federal, state or local agencies.
<br />PERMIT TO OPERATE an UST FACILITY issued to; _,OUTPL AND CORPCHRATION
<br />146 GOLD CAMP DR _,?L- _:r 0
<br />RANCHO CORDOVA, CF 9561 !
<br />PERMIT'_ TO OF'ERATE and ANNUAL PERMIT FEE PAY'MENT'S
<br />and may be SUSPENDED or REVOKED for
<br />THIS FORM MUST BE [)II `icey' yEo C -N, IDl02CMKSLI°
<br />"&
<br />UL FA 1,71v 77 ELE*1JFN :=TORE #144117,
<br />272S COUNTRY CLUE
<br />ST!_!CKTOiv, CA 95204
<br />SOUTHLAND CORPORATION
<br />3146 GOLD CAMP DR STE i)0
<br />RAINC:HO C:ORDOVA, C;A 956-t?
<br />are NOT TRANSFERABLE
<br />cause.
<br />ON THE RRE"I, ._P
<br />Facility jii; :ji:i;_;',; ;•
<br />Permit Printe _':i 1 1
<br />,s 0
<br />Tar,v
<br />Tank
<br />Permit
<br />PiE
<br />Number
<br />Record IR
<br />number
<br />C a
<br />aF .1ty
<br />Contents
<br />Permit $tat1:5
<br />Annual Permit Fee
<br />?90-001
<br />2380
<br />001
<br />Or" -2
<br />TA107301
<br />00457`:
<br />iG,t!:?
<br />Ut,leaaed
<br />) +.
<br />Pern':
<br />From T_
<br />:, --;.,
<br />01/0.?J5
<br />n
<br />003
<br />TA107302
<br />TAIC!7303
<br />004674
<br />904676
<br />101010
<br />10,tYJ<1
<br />IJrleaded
<br />Unleaded
<br />i gttive
<br />Active Permit01101/95
<br />01 Active Permit
<br />01!01/95
<br />PERMIT CONDITIONS:
<br />:) The PERMIT T1 OPERATE will: become void if ANiv`LKk_ PERMIT Fees and SERVICE Fees are not paid andlrr the LIST sYstem(s) iai_s
<br />to remain in compliance with the PERMIT CONDITIONS.
<br />2) The PERMIT TI' OPERATE is granted t4a the TANK, O'WPER who accepts regporsibilif.v for operating and monitoring the I)OT systes,,
<br />according to State underground storage tank laws and regulations as well as any conditions established by :San Tcaquin, County.
<br />3:! The TANK OPERATOR(S), if different from the tank owner, shall operate and r,,nitor the UST system according to the WRI-TE'
<br />OPERATING AGREEMENT required under Section 25233, Chapter 6.7, Division 20, California 'Health and Safety CNie.
<br />4` The TANK OWNEP shall notify the Environmental Healt:, Division of any Proposed change in operation or ownership of the UST
<br />system.
<br />S) t!pon any change in equipment, design or operation of this facility, tte PER TO OPERATE will be reviewed by the
<br />Environmental Health Division.
<br />6) A construction, or removal permlt is requires; from the Environmental Health Division Prior to any removal or
<br />change of UST system equipment.
<br />Ti This PERMIT TO OPERATE shall not be considered Permission to violate any e=.icting laws, ordinances or statutes of other
<br />federal, state or local agencies.
<br />PERMIT TO OPERATE an UST FACILITY issued to; _,OUTPL AND CORPCHRATION
<br />146 GOLD CAMP DR _,?L- _:r 0
<br />RANCHO CORDOVA, CF 9561 !
<br />PERMIT'_ TO OF'ERATE and ANNUAL PERMIT FEE PAY'MENT'S
<br />and may be SUSPENDED or REVOKED for
<br />THIS FORM MUST BE [)II `icey' yEo C -N, IDl02CMKSLI°
<br />"&
<br />UL FA 1,71v 77 ELE*1JFN :=TORE #144117,
<br />272S COUNTRY CLUE
<br />ST!_!CKTOiv, CA 95204
<br />SOUTHLAND CORPORATION
<br />3146 GOLD CAMP DR STE i)0
<br />RAINC:HO C:ORDOVA, C;A 956-t?
<br />are NOT TRANSFERABLE
<br />cause.
<br />ON THE RRE"I, ._P
<br />Facility jii; :ji:i;_;',; ;•
<br />Permit Printe _':i 1 1
<br />,s 0
<br />
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