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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E.Weber Ave.,Third Floor• Stockton,CA 95202-2708•Phone(209)468-3420 Donna Herm,REH.S.,Director ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE Penni[ Program Permit Valid Record ID Number Program Code and Description PR023151 2300-UNDERGROUND STORAGE TANK FACILITY 111/2002 To 12/31/2002 Underground Storage Tank Program: California Health and Safety Code_Div.20,Cl;.6,7 and Title 23 California_Code Of Requla0ons Chap,�6._ -_--_---_--_----__-__-_--_------------------------ --------- --------- � .,.a".� Permit Status System Type P/E Tank# Ta k Reco d ID P rm t n P y Active billable DOUBLE WALLED co u I to va i 2360 2 390002315170151702 PT0004113 515 M ton s Active,billable DOUBLE WALLED Continuous Interstitial 2362 1 390002315170151701 PT0004112 1,000 Mondonn9 Underground Storage Tank Permit Conditious 1) The Permit to Operate will become void if Annual Permit Fees and Service Fees are not paid and/or the U5'f systems)fails to remain in compliance with there Permit Conditions. 2) In order to maintain the operating PemuL 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 established by San Joaquin County. 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[he tank,the Permittee shall ensure That both the Tank Owner and tank Operator receive a copy of the permit. 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Environmental Health Department(EHD)and are wmidererd UST Permit Conditions- The approved monitoring,response,and plot plans shall be maintained onsite with the permit 5) The Pamdttee shall comply with the monitoring procedures referenced in this pemdt. 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 provide documentation of such servicing to this office. 7) In the event of a 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. g) 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 performed. 9) The EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change. 10) Upon any change in equipment,design or operation of the UST system(including change in tank conterm or usage),the Permit to Operate will he subject to review,modification or revocation. of 11) Construction,repair and/or removal permits are required from the EHD prior in any change,repair or removal th UST system equipment 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 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. 14) A"Conditional'Permit maybe revoked if corrections specified on the inspection report are not completed by the date(s) indicated. PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: CHEROKEE MEMORIAL PARK INC DBA: CHEROKEE MEMORIAL PARK THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Facility ID FA0003689 Regulated Facility: CHEROKEE MEMORIAL PARK Account ID AR0003267 13823 N BECKMAN RD Issued 3129/2002 LODI. CA 95240 Billing Address: ATTN : CHEROKEE MEMORIAL PARK CHEROKEE MEMORIAL PARK PO BOX 1000 D LODI, CA 95240 7023.rpt