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* SAN JOA( COUNTY PUBLIC HEALTH SEI&CES 304 E.WEBER AVE.,THIRD FLOOR - STOCKTON,CA 95202 - PHONE(209)468-3420 KAREN FURST, M.D., M.P.H., HEALTH OFFICER DONNA HERAN,R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO RATE ermit Program errmt Program Code and Description Valid Record ID Number g 1/1100 To 12/31/00 PRO50672 2300-UNDERGROUND STORAGE TANK FACILITY Underground Storage Tank Program_ California Health and Safety Code Div.20,Chap.6.7 and Title 23 California Code of Regulations Chap. 16. - - - _ -- --- _ - - - -- ---_ - - - - - - - - - _ - - - --- ---- - - - - - -- ermi apace y - ens - erns a us System ype e " e cc i n ana or Active ir,rriin 1, DOUBLE WALLED ELECTRNC L LEAK DTEC 2360 2 390005067240506726 PT0009030 6,000 PREMIUM UNLEADED Active DOUBLE WALLED ELECTRNC L LEAK DTEC 2360 1 390005067240506725 PT0009029 12,000 REGULAR UNLEADED Active Underground Storage Tank Permit Conditions 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 these Permit Conditions. 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 an 18,as well as any conditions established by San Joaquin County. 3) If the Tank 0perator(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 Perrutkee shall ensure that both the Tank Owner and tank Operator receive a copy of the permit. sidererd 4) Written UST Permit Monitoring gtiorro Copies of an the Procedures and Emergeonse ncy Responsn must be e Planmusted by theatt hed oEnvironmeth slpermittor be availivision able for rreevie'w+and/or and are con at�the UST site. 5) I he f'ermttteet shall comply with the monitoring procedures referrenced in this permit. 6) The Permittee shall perform testing and preventive maintenance on all leakdetection monitoring equipment annually,or more frequently if specified by the equipment manufacturer, and provide documentation of such servicing to this office. 7) In the event of a spill,leak,or other unauthorized release,the Permttee shall comply with the requirements of"Title 23 CCR,Chap. 16,Art.5,and the approved Emergency Response Plan. 8) from the dao itten records f all monitoring n it was performed shall be maintained on-site by the operator and be available for inspection for a period of at least three years 9} The PHS/EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change. 9) Upon any HD shall ll equipment,design or operation owners the UST system(including change in tank contents or usage),the Permit to Operate will be subject to review,modification or revocation. d from the P1�S1EH0 prior to any change,repair or removal of UST system equipment. 11) Construction,repair and/or removal permits are require ting compliance with the UST Permit Conditions within 30 days of the anniversary date of the issuance 12) The Permittee shall submit an annusl report documen of this permit. l3) This Permit to Operate shall not be considered permission to violate any laws,ordinances or statutes of any other Federal,State or Local agency. 14) A"Conditional"Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. r PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: GEWEKE FAMILY LP III Tank Owner: GEWEKE FAMILY LP IV THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Facility ID FA0007594 Regulated Facility: GEWEKE FAMILY LP III* Account ID AR0012280 1111 E KETTLEMAN LN Issued 9129/2000 LODI, CA 95240 Bilking Address. ATTN : GILLESPIE, DALE GEWEKE FAMILY LP III" 1111 E KETTLEMAN LN LODI, CA 95240 7023.rpt