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SAN JOAQUIN COUNTY ENVIAbN HNTAL HEALTH DEPARTMENT
<br /> 1868 E. Hazelton Ave. • Stockton, CA 95205-6232 • Phone (209) 468-3420
<br /> Donna Heran,R.E.H.S., Director
<br /> ENVIRONMENTAL HEALTH
<br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br /> PERMIT TO OPERATE
<br /> Program Permit - Permit
<br /> Record ID Number Program Code and Description Valid
<br /> --PR0328259=-- T00t9745=-222V--SM -- ous-NmSTEGENERAfi6R-F=LI _ _—_.... _-____.1III F9014_T
<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 aeq and Title 22,California Code of Requlations,Chap.20------------
<br /> _ _ ,
<br /> PRO527629 2300 UNDERGROUND STORAGE TANK FACILITY 11112013 To 12/3112013
<br /> Underground Storage Tank r r
<br /> California Health and Safety ode, Div.20,Chap.6.7 and Title 23,California Code of Requlations,Chap_16. _____
<br /> P/E Tank M Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection
<br /> 2352 1 390005276290515840 PT0019359 30,000 REGULAR UNLEADED Active,billable DOUBLE-WALL Continuous Interstitial Monitoring
<br /> 2350 2 390005276290515841 PT0019360 30,000 REGULAR UNLEADED Active,billable DOUBLE-WALL Continuous Interstitial Monitoring
<br /> 2350 3 390005276290515842 PT0019361 30,000 PRE Ilyl Ufyl UNL DED Active,billable DOUBLE-WALL Continuous Interstitial Monitoring
<br /> BOE ID#: 44039100 0 �'"a6 Ii+l,{4(I
<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 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 Operator(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,the Pernittee 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 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 a spill,leak,or other unauthorized release,the Permitee shall comply with the requirements of Title 23 CCR,Chap.16,An.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 /> perfomin ed.
<br /> 9) The 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 of the UST system(including change in tank contents or usage),the Permit to Operate will be subject to review,modification or
<br /> revocation.
<br /> 11) Construction,repair and/or removal permits are required from the EHD prior to any change,repair or removal of UST system equipment.
<br /> 12) 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 /> 13) A"Conditional'Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated.
<br /> --------------------------------------------------------- ----------------------_"----.-.-.....-.-------.--------------------_----------------"--...........--.......-..------------------.-....
<br /> PERMITS TO OPERATE may be SUSPENDED or REVOKED for cause.
<br /> PERMIT(s) Valid only for: COSTCO WHOLESALE CORPORATION
<br /> DBA: COSTCO
<br /> Tank Owner: COSTCO WHOLESALE, ATTN: LICENSING
<br /> THIS FORM MOIST DE DISPLAYED CONSPICUOUSLY ON THE PREMISES — r
<br /> COSTCO WHOLESALE #1031 FacilitylD FA0018721
<br /> Regulated Facility:
<br /> 2440 DANIELS ST Account ID AR0033237
<br /> MANTECA CA 95336 Issued 2/19/2013
<br /> Billing Address: ATTN : LICENSING DEPT
<br /> COSTCO WHOLESALE #1031
<br /> PO BOX 35005
<br /> SEATTLE WA 98124-3405
<br /> 7023.rpt
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