BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES 304 E.WEBER AVE.,THIRD FLOOR • STOCKTON,CA 95202 • PHONE(209)468-3420 KAREN FURST, M.D., M.P.H., HEALTH OFFICER DONNA HERAN, R.E.H.S.,DIRECTOR ENVIRONMENTAL HEALTH DIVISION ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE Permit Program Permit Record 11) Number Program Code and Description Vaud PR0231517 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/01 To 12/31/01 Underground Storage Tank Proaram: California Health and Safety Code Div,20,Chap,6.7 and Title 23 California Code of Regulations Chap_16__________ _ ___________ _ ____ ______ P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type 2360 2 390002315170151702 PT0004113 515 OTHER Active DOUBLE WALLED 2362 1 390002315170151701 PT0004112 1,000 OTHER Active DOUBLEWALLED BOE 104-44-024731-77 Underground Storage Tank Permit Conditions 1) The Pernrit to Operate will become void if Annual Permit Fees and Service Fees are not paid and/or the UST system($)fails to remain in compliance withihese Permit Conditions. 2) In order to 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 any conditions established by San Joaquin County. 3) If the Tank Opentur(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 shag ensure that both the Tank Owner and tank Operator receive a copy of the permit. 4) Written Monitoring Procedures and an Emergency Response Pimmust be appmved bythe Environmental Health Division(PHS/EHD)andare considerml UST Permit 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 USr site. 5) The Permittee shall comply with the monitoring procedures referenced in this permit. 6) The Pamittm shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently if specified bythe equipment manufacturer,and provide documentation ofsuch servicingto thisoffuce 7) In the eventof a spill,leak,or other unauthorimdrelease,the Permitee shag 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 shag be maintained on-site by the operatorand be available for inspection fora period of at least three year Gam the date the monitoring was performed. 9) The PHS/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 ofthe UST system(including change in tank contents or usage),the Permit to Operate will be subject to review, modification or revocation. 11) Construction,repair and/or removal permits are required from the PHS/EHD prior to any change,repair or removal of 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 Pemdt 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 may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. PERMITS TO OF 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 3/29/2001 LODI. CA 95240 Billing Address: ATTN : CHEROKEE MEMORIAL PARK CHEROKEE MEMORIAL PARK PO BOX 1000 D LODI, CA 95240 7023.rpt �••�