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SAN JOAqWN COUNTY PUBLIC HEALTH $VICES <br /> P O Box 388 WSTocKTON, CA 95201-0388 • PHoNE ) 468-3420 <br /> ERNEST M. FUJIMOTO, M.D., M.P.H., ACTING HEALTH OFFICER <br /> DONNA RERAN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br /> ENVMONIENTAL HEALTH <br /> OPERATING- PERMIT FCvi UNDERGROUND 'SIORAGiE iANK FACILITY <br /> Tar*: Tani- Permit Annual Pe.Ff14t Fee Valid <br /> HE _ Whber Record ID !N--fiber Capacity Contents Permit Status � =r`•e _ To <br /> ZINO 004 TA163104 0114141 1=:0001 Unlaaded 01 Active Pera;it Ili1il35 12131/95 <br /> 23slow <br /> OAS TA163105 004142 10,000` Unleaded Ol Active Permit MP01P35 12i3i/95 <br /> 23t* ON TA163106 004143 ,00O Unleaded 01 Active Permit Ol101195 12131/95 <br /> PERMIT CCONDITIONS: <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 <br /> to remain in compliance with the PERMIT M. DITIONS. <br /> 2) The PERMIT TO OPERATE is granted to the TANK INNER wto accepts responsibility for operating and monitoring tha LIST system <br /> according to State underground storage tank taws arra regulations as well as any conditions established by Sar Joaquin 0junty. <br /> 3) The TANK OPERATOR(S), if different frc4 the tank owner. stall operate and monitor the UST system according to the WRITTEN <br /> OPERATING AGREEMENT required under Section 25,33, Chapter 6.7, Division '_'0, California health and Safety Code. <br /> 4) The TANK. OWNER shall notify the Environmental Health Division of any Proposed change in operation or ownership of the UST <br /> system. <br /> 5) Upon any change in equipment, design or operation of this facility, the PERMIT TO OPERATE will be reviewed by the <br /> Environmental Health Division. <br /> 6) A construction or removal permit is required fr,xn the Environmental Health Division prior to any removal or <br /> change of UST system eceiipment. <br /> 7) This PERMIT TO OPERATE shall riot be considered permission to violate ani existing laws, ordinances or statutes of other <br /> federal, State or local agencies. <br /> PERMIT TO OPERATE an UIT FAC1LiTY issued to; TIME OIL. CO <br /> O <br /> PO BOX 24447 <br /> ,:EATTLE, WA 98124 <br /> PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause . <br /> a A4 f: <br /> THIS PORm MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> REGULATED FACILITY; 3ACKPOT FOOD MART Account 17; 0000090 <br /> 14000 E 14WY Facility ID; 000091 <br /> LF-Cl EFORD, CA 952=7 Permit Printed; 08,/10..''•=15 <br /> BILLING ADDRESS; <br /> JAC:KPCOT FC OC iD MART <br /> PO BO:;X 24447 TERMINAL ST <br /> ,;CATTLE. WA +r,1^4-:12447 <br />