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SAN JOAQUIN COUNTY ENVTRONAHNTAL 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 to Number Program Code and Description Valid
<br /> PR0521946_____PT0014840_2220=SMALL QUANTITYHAZARDOUSWASTE-GENERATOR FACILITY- _ _-1/1!2013–T�12/31/2013---
<br /> Hazardous Waste Generator Pro6ram�- -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.-25-1.0-0-et_ seq,and Title 22, rma Code of Regulations,Chap._20.
<br /> PROSIB288 300- NDERGROUND STORAGE TANK FACILITY 1/1/2013 To 12/3112013
<br /> Under round Stora Tank P o r
<br /> California Health and Safety Code, Div.20, Chap. 6.7 and Title 23, California Code of Regulations,Chap. 16.
<br /> /E Tank 4 TaunkRecord ID Penni[# Capacity Contents Permit Status System Type Leak Deteenon
<br /> 2362 1 390005182880515627 PT0011948 20,000 REGULAR UNLEADED Active, billable DOUBLE-WALL continuouslnterstitial Marinating
<br /> 2360 2 390005182880515628 PT0011949 20,000 REGULAR UNLEADED Active, billable DOUBLE-WALL Continuous Interstitial Monitoring
<br /> 2360 3 390005182880515629 PT0011950 20,000 PREMIUM UNLEADED Active,billable DOUBLE-WALL Continuous lnteratiliat Monitoring
<br /> BOE ID#: 44039100
<br /> Underground Storage Tank Permit Conditions
<br /> I) 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 Operators)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) W rinrn 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 Pemninee 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 spill,leak,or other unauthorized release,the Pernitee 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 he 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 my 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 MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> COSTCO GASOLINE FAC #658 Facility ID FA0013810
<br /> Regulated Facility:
<br /> 3250 W GRANT LINE RD Account ID AR0023237
<br /> TRACY CA 95377 Issued 3/13/2013
<br /> Billing Address: ATTN : LICENSING
<br /> COSTCO GASOLINE FAC 4658
<br /> PO BOX 35005
<br /> SEATTLE WA 98124-3405
<br /> 7023 rpt
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