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E_.ViRONMENTAL HEAL,.{ POST ON PREMISE <br />lssue0: EXPIRES: PERMIT NO. <br />December SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />- -- -- - ENVIRONMENTAL HEALTH DIVISION <br />Permit Issued to: 1601 E. HAZELTON AVE. • PHONE 468-3420 <br />P.O. BOX 2009 • STOCKTON, CA 95201 <br />JACKPOT <br />1347S N. JACK TONE ROAD OPERATING PERMIT FOR UNDERGROUND <br />LODI, CA 95240 <br />STORAGE TANK FACILITY <br />Status, Oi iD No; JACKPIJ <br />VINCE BLANK'TIME OIL COMPANY TANK OWNER t lfic 1� .Ui'il r1 <br />2737 W. COMMODOREWAY2737 W. COMMODORE WAY <br />SEATTLE, WA. 98199 SEATTLE, WA ga15a <br />NUMBER OF TANKS 06 <br />Tank Description Product :.aPaciiy LDM Status <br />-- ------------------------------------- --- ------ <br />0001 TANKS Motor Vehicle Fuel 10,000 S 01 <br />0002TANKS Motor Vehicle Fuel 12,000 S 01 <br />000; TANK' Motor Vehicle Fuel 6,000 S 01 <br />0005 TANKS: Motor Vehicle Fuel i,UO{a i2 <br />0005 TANKS Motor Vehicle Fuel 1,000 12 <br />0006 TANKS Motor Vehicle Fuel CF 12 <br />CONDITIONS <br />1. This permit expires on December 31, of the current year. Inspection fee will be billed annually. <br />2. This permit is granted to the tank owner who accepts responsibility for operating and monitoring the tank <br />system according to state underground storage tank laws and regulations and conditions set by the county. <br />3. Tank operators, if different than the owner, shall operate and monitor the tank system according to the <br />written operating agreement required under Section 25293, Chapter 6.7, Division 20, California Health and <br />Safety Code. <br />4. Tank owner shall notify the Environmental Health Division of any proposed change in operator or ownership <br />of tank system. <br />5. Upon a significant change in design or operation of this facility, permit will be reviewed by the <br />Environmental Health Division. <br />6. This permit cannot be considered as permission to violate existing laws, ordinances, regulations or statutes <br />of other governmental agencies. <br />Jogi Khanna, M.D., MPH <br />Health Officer <br />NON-TRANSFERRABLE <br />THIS PERMIT MAY BE SUSPENDED OR REVOKED FOR CAUSE <br />Ron VaNnoti, REHS, Director <br />Envir sntal Health Division <br />;r/ <br />