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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 304 E.Weber Ave.,Third Floor•Stockton,CA 95202-2708• Phone(209)468-3470
<br /> Donna Henn,RE.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 /> PRO513780 PT0009975 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/2004 To 12/31/2004
<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 seq,and Title 22,California Code of Regulations,Chap.20._____ __ _ _
<br /> PR0231631 2300-UNDERGROUND STORAGE TANK FACILITY 1/112004 To 12/31/2004
<br /> Underground Storage Tank Program:
<br /> California Health and Safety Code,Div.20,Chap. and Title 23,California Code of Regula0ons,Chap,16. _ ___ _ _I-----------------------
<br /> P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection
<br /> 2360 6 390002316310163106 PT0004143 8,000 PREMIUM UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial Monitonng
<br /> 2360 5 390002316310163105 PT0004142 10,000 MIDGRADE UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial Monitoring
<br /> 2362 4 390002316310163104 PT0004141 12,000 REGULAR UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial Monitoring
<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 systems)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) Ifthe 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 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 Depatiment(EHD)and are considen.rd UST Permit Conditions. The approved
<br /> monitoring,response,and plot plans shall be maintained onsite with the pecont
<br /> 5) The Pemuttec 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 Pemmitee shall comply with the requirements of Tide 23 CCR,Chap.16,Art 5,and the approved Emergency Response Plan.
<br /> 8) Written records ofall monitoring performed shall be maintained on-site by the operator and be available for inspection for a period oral least three years fiom the date the monitoring was
<br /> performed.
<br /> 9) The EHD shall be notified of any change in ownership or operation ofthe 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 /> 11) Mff&&16n,repair and/or removal permits are required from the EHD prior to any change,repair or removal of UST system equipment
<br /> 12) The Pemrittee shall submit i m annual report documenting compliance with the UST Perrrdt Conditions within 30 days of the 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'Permit maybe revoked if corections specified on the inspection reportare not completed by the date(s) indicated-
<br /> PERMITS
<br /> ndicatedPERMITS 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(LOCKEFORD)
<br /> - THIS FORM MUST BE DLSPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> Regulated Facility JACKPOT FOOD MART* Facility ID FA0000091
<br /> 14000 E HWY 88 Account ID AR0000090
<br /> LOCKEFORD, CA 95237 Issued 411/2004
<br /> Billing Address:
<br /> JACKPOT FOOD MART*
<br /> 2737 W COMMODORE WAY
<br /> SEATTLE, WA 98199
<br /> 7023.rp1
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