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SAN JOAI�tjIN COUNTY PUBLIC HEALTH S,.,VICES <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 HERRN,R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> Valid <br /> Program <br /> erne[ Valid <br /> Record ID Number Program Code and Description <br /> PR023186 2300-UNDERGROUND STORAGE TANK FACILITY 1/1100 To 12/31100 <br /> Underground Storage Tank Program: <br /> California Health and Safety Code Div.20,Chap.6.7 and Title 23 California Code of Regulations Chap. 16.. Y Y <br /> _ _ _ _ _ _ _ _ _ cor i i mi us m <br /> FIE IMIC9 <br /> Conditional <br /> Underground Storage Tank Permit Conditions <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 to remain in compliance with <br /> these Permit Conditions. g <br /> 2) In ars well maintain <br /> conditionseoper ting permit,ished the <br /> San mitJoaholder <br /> County. <br /> 3) <br /> comply with the H&S Code,Div.20,Chap.6.7 and 6.75;and CCR Title 23,Chap. 16 and <br /> 3) IftheTank 0 crator(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 <br /> Permittee shaalll ensure that bah the Tank Owner and tank Operator receive a cporpy of the permit. (P <br /> rerd <br /> be <br /> alth <br /> 4) Written Monitoritig Procedures and an US�6TPtermi Condiitions. Copiesfthe Procedures and Emergency Response Plan musoved t beeattached ethis 1permit or be aaitable for review and/or inspection <br /> 5) YIr2"ePetaritt�Seshall 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 <br /> equipment manufactureq and provide documentation of such servicing to this office. <br /> 7) In the event of a spill,leak,or other unauthorized release,the Pemiitee shall comply with the requirements of Title 23 CCR,Chap. 16,Art.5,and the <br /> 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 <br /> from the date the 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 of the UST system (including change in tank contents or usage),the Penn it to Operate will be subject to <br /> review,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 <br /> of this 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: PACIFIC BELL ENVIRONMENTAL MGT <br /> DBA: PACIFIC BELL <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: PACIFIC BELL Facility ID FA0003958 <br /> 1413 BOURBON ST Account ID AR0003571 <br /> STOCKTON, CA 95204 Issued 9/2812000 <br /> Billing Address: ATTN : ENVIRONMENTAL MGMT <br /> PACIFIC BELL <br /> PO BOX 5095 RM 3E000T <br /> SAN RAMON, CA Q4583-0995 <br /> 7023.rpt d <br />