|
SAN JOA(P wCOUNTY ENVIRONMENTAL I IEALTimohEPARTMENT
<br /> 304 E.Weber Ave.,Third Floor•Stockton,CA 95202-2708• Phone(209)468-3420
<br /> Donna Horan, REH.S.,Director
<br /> ENVIRONMENTAL HEALTH
<br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br /> PERMIT TO OPERATE
<br /> Program Permit
<br /> Record ID Number Program Code and Description Permit
<br /> PR0518923 PT0012257 2220
<br /> -,SMQUANTITY HAZARDOUS WASTE GENERATOR FACILITY Valid
<br /> haearclguy�ate Generator Program: 12007 To 12/31/200;
<br /> California Health and Safety Code,Div.20 Chap.6.5,Art.2-13,Sec 25100 et seq,and Tithe 22,California Code of Regulations,Chap.20.
<br /> PR0516736 2300-UNDERGROUND STORAGE TANK FACILITY
<br /> Underground Storage Tank Prooram' 1/1/2003 To 12(31/2003
<br /> Califomia Health and Safety Code,Div.20,Chap.6.7 and Tithe 23,Califomia Code of Re ulations,Cha 16.
<br /> ------- -----
<br /> --------------9-- --- --------P=------------- ----- ------- --
<br /> P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status S stem"r
<br /> 2360 3 390005167360515559 PT0011474 10,000 REGULAR UNLEADED y Type_ Leak Detection
<br /> 2360 2 390005167360515558 PT0011473 10,000 REGULAR UNLEADED Active,billable DOUBLE WALLED continuous IntersGhal Monitoring
<br /> 2362 1 390005167360515557 PT0011472 20,000 REGULAR UNLEADED 'fictive,billable DOUBLE WALLED continuous Interstitial Monitoring
<br /> Active,billable DOUBLE WALLED continuous Interstitial Monllonng
<br /> Underground Storage Tank Permit Conditions
<br /> fii�
<br /> 1) The Permit 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 Conditions.
<br /> 2) In order to maintain the operating permit,the owner and operator shall comply with the H&S Code,Div,20,Chap.6.7 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 Operators)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,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 must be approved by the Environmental Health Department(EHD)and are considerer]UST Permit Conditions. The approved
<br /> monitoring,response,and plot plans shall be maintained onsite with the perrut.
<br /> 5) The Penndtme 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 ifspecitied 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 Permime 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 be available for inspection for a period of at least three years from the date the monitoring was
<br /> performed.
<br /> 9) The EIID 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 tank contents or usage),the PemniI to Operate will be subject to review,modification or
<br /> 11) Mffi 8Lgfbn,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 Conditions within 30 days of the anniversary date 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,State or Local agency.
<br /> 14) A-Conditional"Perrin may be revoked if corrections specified on the inspection report are not completed by the dam(s) indicated.
<br /> PERMITS TO OPERATE are NOT TRANSFERABLE
<br /> and may be SUSPENDED or REVOKED for cause.
<br /> PERMIT(s)Valid only for: DENNIS JACOBSEN FAMILY HOLDING
<br /> DBA: SAFEWAY STORE#1769
<br /> THIS FORM MUST BE DISPLAYED CONSPICOOUSLY ON'fHE PREMISES
<br /> Regulated FacilitySAFEWAY FUEL CENTER#1769
<br /> Fadrty ID cc0012764
<br /> 21335
<br /> 2808 COUNTRY CLUB BLVD Aount ID AR
<br /> STOCKTON, CA 95204 AR0021335
<br /> Issued 8/19/2003
<br /> Billing Address: ATTrN MS #6516 TAX, NASC
<br /> SAFEWAY FUEL CENTER #1769
<br /> PO BOX 29096
<br /> PHOENIX, AZ 85038-9096
<br /> 7023.rpt
<br />
|