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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <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 ED Number Program Code and Description Valid <br /> PR0231849 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/01 To 12131/01 <br /> Underground Storage Tank Program: <br /> California Health and Safety Code Div.20,Chap,6.7 and Tide 23 Califomia Code of Regulations Chap_t6__________ ___ _____ ______ ___ __ ____ <br /> P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection <br /> 2360 6 3900023184901134906 PT0004634 7,500 OTHER Active DOUBLEWALLED AUTOMATIC TANK GUAGE <br /> 2360 5 390002318490184905 PT0004633 1,000 UNLEADED Active DOUBLE WALLED AUTOMATIC TANK GUAGE <br /> 2362 4 39000 23 18490184904 PT0004632 6,000 OTHER Active DOUBLE WALLED AUTOMATIC TANK GLADE <br /> BOE 1[)#: 44-024901 <br /> Underground Storage Tank Per Conditions <br /> 1) The Pernat to Opemte will become void if Annual Perrot Fees and Service Fees are not paid and/crthe UST systems)fails to remain in compliance with these Permit <br /> Conditions. <br /> 2) In order io maintain the operating permit,the pant holder shall comply with the H&S Coda Div.20,Chap.6.7 and 6.75;and OCR,Title 23,Chap. 16 and 18,as well as <br /> any conditions established by San Joaquin County. <br /> 3) If the Tank Opemtor(s)is different from the Tank Owner,or if the Permit to Operate is issued to a person other than the owner"operator of the tank,dere Permittee shall <br /> ensure that both the Tank Owner and tank Operabr receive a copy of the permit. <br /> 4) Written Monibring Procedures and an Emergency Response Plan must be approved by the Environmental Health Division(PHS/EHD)and are consider erd UST Permit <br /> Conditions. Copia of the Procedures and Emergency Response Plan most be attached to this perntit or be available for review and/or inspection at the USC site <br /> 5) The Permittee shall comply with the monitoring procedures referrenced in this permit <br /> 6) The Per notice shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently if specified by the equipment <br /> mann f icturer,and provide documentation ofsuch servicing to this office. <br /> 7) In the event of a spill,leak,or other unauthorized release,the Permitee shall comply with the requirements of Ttle 23 CCR,Chap.16,Art.5,and the approved Emergency <br /> Response Plan. <br /> 8) Written records of all monitoring performed shall be maintained on-site by the operatorand be available for inspection fora period of at least three)ears 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 Permit to Operate will be subject to 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 of the issuance ofthis permit. <br /> 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. <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: SJC MOSQUITO&VECTOR CTRL <br /> Tank Owner: SAN JOAQUIN CO MOSQUITO ABATEM <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: SJ CO MOSQUITO &VECTOR CTRL Facility ID FA0003762 <br /> 200 N BECKMAN RD Account ID AR0003341 <br /> LODI. CA 95240 Issued 3/29/2001 <br /> Billing Address: ATTN : SAN JOAQUIN CO MOSQUITO ABATEM <br /> SJ CO MOSQUITO&VECTOR CTRL <br /> 7759 S AIRPORT WY <br /> STOCKTON, CA 95206 <br /> 7023.rpt 10/ �.0 <br />