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SAN J0 IN COUNTY PUBLIC HEALTH ' VICES <br /> 304 E. WEBER AVE.,THIRD FLOOR • STOCKTON,CA 95202 • PHONE(209) 468-3420 <br /> KAREN FORST, M.D., M.P.H., HEALTH OFFICER <br /> DONNA HERAN, R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DwimN <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> Program Permit Permit <br /> Record ID Number Program Code and Description Valid <br /> PRO506724 2300-UNDERGROUND STORAGE TANK FACILITY 111/01 To 12/31/01 <br /> Underground Storage Tank Pro ram: <br /> California Health and Safety Cade Div_20,Chap_6.7 and Title-2-3-California Code of Regulations Chap. 16_ __ - - --- - -- - -- --- ------- - - -- <br /> P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection <br /> 2360 3 390005067240506727 PT0009031 6,000 DIESEL Active DOUBLE WALLED ELECTRNC L LEAK DTEC <br /> 2360 2 390005067240506726 PT0009030 6,000 PREMIUM UNLEADED Active DOUBLE WALLED ELECTRNC L LEAK DTEC <br /> 2362 1 390005067240506725 PT0009029 12,000 REGULAR UNLEADED Active DOUBLE WALLED ELECTRNC L LEAK DTEC <br /> Underground Storage Tank Permit Conditions <br /> I) 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 these Permit <br /> Conditions. <br /> 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 <br /> any con ditions established by San Joaq ui n County. <br /> 3) If the Tank Operators)is d ifferent from the Tank(honer,or if the Permit to Operate is issued to a person other than the owner or operator of the tank,the Permittee shall <br /> en sure that both the Tank Owner and tank Operator receive a copy of the permit. <br /> 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Environmental Health Division(PHS/EFID)and are considcrerd UST Permit <br /> 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 UST site. <br /> 5) The Permittee shall comply with the monitoring procedures referrenced in this permit. <br /> 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently i f specified by the equipment <br /> manufacturer,and provide documentation ofsuch servicing to this office. <br /> 7) In the event of a spill,leak,or other unauthorized release,the Permitce shall comply with the requirements of Title 23 CCR,Chap. 16,Art.5,and the approved Emergency <br /> Response Plan. <br /> S) Written records of all monitoring performed shall be maintained on-site bythe operatarand be available for inspection fora period ofat least three years from the date the <br /> monitoring was performed. <br /> 9) The PHSIEHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change. <br /> 10) Upon anychange in equipment,design or operation ofthe UST 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 USC Permit Conditions within 30 days ofthe anniversary date ofthe 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 SUSPENDER or REVOKED for cause. <br /> PERMiT(s)Valid only for: GEWEKE FAMILY LI' III <br /> Tank Owner: GEWEKE FAMILY LP IV <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: GEWEKE FAMILY LP III* Facility ID FA0007594 <br /> 1111 E KETTLEMAN LN Account ID AR0012280 <br /> LODI. CA 95240 Issued 3129/2001 <br /> Billing Address: ATTN : GILLESPIE, DALE <br /> GEWEKE FAMILY LP III* <br /> 1111 E KETTLEMAN LN <br /> LODI, CA 95240 <br /> 7023.rpt lip <br />