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SAN JOAN COUNTY PUBLIC HEALTH S&CES <br /> 304 E.WEBER AVE.,THIRD FLOOR • STOCKTON,CA 95202 • PHONE(209)468-3420 <br /> KAREN FURST,M.D.,M.P.H., HEALTH OFFICER <br /> DONNA HERAN,R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> Program Permit Permit <br /> Record 11) Number Program Code andIkscriptim Valid <br /> PRO513780 PT0009975 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1101 To 12/31/01 <br /> Hazardous Waste Generator Program: <br /> California Health ard_Safety Code Div_20_Chap_6.5,-Art.-2--13 Sec.25100 et seq,and Tide 22 California Code of Regulations,Chap.-20. __ _ ____ <br /> PR0231631 2300-UNDERGROUND STORAGE TANK FACILITY 1/1101 To 12131/01 <br /> Underground Stora a Tank Pro <br /> California Health and Safety Code_ ,_0,Chap,6.7 and Title 23 Califomia Code of Regulations Chap_16_________ _ __ ________________ <br /> P/E Tank# Tank Record ID Permit# Capacity Contents Permit Stains <br /> 2360 6 390002316310163106 PT0004143 8,000 UNLEADED Active <br /> 2360 5 390002316310163105 PT0004142 10,000 UNLEADED Active <br /> 2362 4 390002316310163104 PT0004141 12,000 UNLEADED Active <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/cr the UST system(s)fails to remain in compliance with these Permit <br /> Conditions. <br /> 2) In order b maintain the operating permit,the permit holder 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 <br /> any conditions established by San Joaquin County. <br /> 3) If the Tank Operators)is d ifferent 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 <br /> ensure that both the Tank Owner and tank Operabr receive a copy of the permit. <br /> 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Environmental Health Division(PHS/EHD)and are considaerd UST Permit <br /> Conditions. Copies of the Procedures and Emergency Response Plan must be attached to this permit or be available for review and/or inspection at the UST site <br /> 5) The Permittee shall comply with the monitoring procedures referrenced 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 <br /> menu(aclurer,and provide documentation ofsuch servicing to this office. <br /> 7) In the event of a spill,leak,or other unauthorized release,the Per mitee shall comply with the requirements of Title 23 CCR,Chap.16,Art.5,and the approved Emergency <br /> Response Plan. <br /> 8) Written records of all monitoring performed shag be maintained on-site bythe operatorand be available for inspection fora period of at least three years from the date the <br /> monitoring was performed. <br /> 9) The PHS/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 ofthe USC system(including change in tank contents or usage),the Per mit to Operate will be subject on review, <br /> modification or revocation. <br /> 11) Construction,repair and/or removal permits are required from the PHS/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 ofthe issuance ofthis permit. <br /> 13) This Pertnit 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 /> THIS FORM MUST BE DISPLAYED 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 3/29/2001 <br /> Billing Address: <br /> JACKPOT FOOD MART' <br /> PO BOX 24447 TERMINAL ST <br /> SEATTLE, WA 98124-2447 <br /> 7023.rpt 6 sk <br />