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ry SAN JOAQUIrrCOUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E.Weber Ave.,Third Floor• Stockton,CA 95202-2708• Phone(209)468-3420 <br /> Donna Heran,RF-H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> Permit <br /> Program Permit Pro m Code and Descri tion Valid <br /> Record ID Number gra p <br /> PRO513780 PT0009975 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/2003 To 12/31/2003 <br /> Hazardous Waste Generator Program: <br /> Califomia Health and Safety Code,Div_20,Chap.6.5,Art_2-13,Sec_2 l... .. seq,and-T--it--e-22:Califomia Code of Regulations,Chap:20- --------------------.' --- - -I-- ' - - - - - <br /> PR0231631 2300-UNDERGROUND STORAGE TANK FACILITY - 1/1/2003 To 1213112003 <br /> Underground Storage Tank Program: <br /> California Health and Safety Code,Div_20,Chap.6_7 and Tide 23,Califomia Code of Regulations,Chap,16._____________.---..___..--_-____-__._.----___--__..._ <br /> P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection <br /> PREMIUM UNLEADED Active,billable DOUBLE WALLED Coil o I t uti I M t ng <br /> 2360 6 390002316310163106 PT0004143 8,000 MIDGRADE UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial Monitoring <br /> 2360 5 390002316310163105 PT0004142 10,000 REGULAR UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial Monitoring <br /> 2362 4 390002316310163104 PT0004141 12,000 <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 syslem(s)fails to remain in compliance with these Permit Conditions. <br /> 2) In order W maintain the operating perm%the owner and operator shall comply with the H&S Code,Div.20,Chap.6.7 and 6.75;and CCR Tide 23,Chap.16 and Is,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 Permittee shall ensure that both <br /> the Tank Owner and conk 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(EIB))and are comidererd UST Pemut Conditions. The approved <br /> monitoring,response,and plot plans shall be maintained onsite with the permit <br /> 5) The Pemuttee shall comply with the monitoring procedures referenced in this permit. <br /> 6) The Pemtinee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or mare 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,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 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 /> 11) LV&%14L%n,repair and/or removal pernits 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"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 /> DBA: JACKPOT FOOD MART (LOCKEFORD) <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facility ID FA0000091 <br /> Regulated Fatuity JACKPOT FOOD MART* Account ID AR0000090 <br /> 14000 E HWY 88 Issued 5/112003 <br /> LOCKEFORD,CA 95237 <br /> Billing Address: <br /> JACKPOT FOOD MART* <br /> 2737 W COMMODORE WAY <br /> SEATTLE, WA 98199 <br /> 7023.rp1 <br />