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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> s 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 /> LnPERATINB PERMIT FOR i.�2ERGROUND STORAGE FANS: FACILITY <br /> Tank Tal. Permit Annual Permit Fee Valid <br /> P/E Number Record IDtwmber Capacity Contents Permit Status From To <br /> 2360 i103 TA152893 904891 S2S Unleaded 01-Activepermit 41/01194 12/31(99 <br /> 260 904 TAl52804 (YA897 52S Diesel 01 Active Permit 01101,199 12/31/99 <br /> PERMIT CONDITION'S: <br /> li The PERMIT TO OPERATE will become void if ANNUAL PERMIT Fees and SERVICE Fees are not paid and/or the O!."_•T systea(s) fails <br /> to remain in compliance with the PERMIT CONDITIONS. <br /> 2) The PERMIT TC OPERATE is granted to the TANK OWNER who accepts responsibility for operating and monitoring the UST system <br /> according to State underground storage taro laws and regulations as well as any conditions established by San Joaquin County. <br /> 3) The TANK. OPERATIONS), if different from the tank owner, shall operate and monitor the UST system according to the WRITTEN <br /> OPERATING AGREEMENT required under Section 253, Chapter 6.7, Division 29, California Health and Safety Code. <br /> 4) The TANK OWNER. shall notify the Environmental Health Division of any proposed change in operation or ownership of the UST <br /> system. <br /> S) Upon any charge in equipment, design or operation of this facility, the PERMIT TO OPERATE will be reviewed by the <br /> EnvironIntal Health Division. <br /> 6) A construction or removal permit is required from the Environmental Health Division prior to any removal or <br /> change of UST system equipment. <br /> 7) This PERMIT '0 OPERATE shall not be considered permission to violate any existing laws, ordinances or statutes of other <br /> federal. state or local agencies. <br /> 4 <br /> PERMIT TO OPERATE an UST FACILITY issued to; LIBERTY RURAL FIRE DISTRICT <br /> 24124 N BRUELLA RD <br /> AC:AMPA, CA 95220 <br /> PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br /> and rrlay be SUSPENDED or REVOKED for cause . <br /> THIS FORM MUST BE DISPIAYEI! CONSPIC4IOUSLY ON THE PREMISES <br /> REGULATED FACILITY; LIBERTY RURAL FIRE DISTRICT Acuunt ID. 0903''x) <br /> ::4124 N BRUELLA RD Facility ID; 003795 <br /> ACAMPO , CA 35220 Permit Printed; 04/28/99 <br /> BILLING ADDRESS; LIBERTY RURAL FIRE DI=-I'RICT <br /> 24124 N BRUELLA RD <br /> ACAMPO, CA 95220 <br />