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BILLING 1985-2000
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231906
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BILLING 1985-2000
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Entry Properties
Last modified
12/15/2023 4:20:11 PM
Creation date
11/5/2018 3:43:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
1985-2000
RECORD_ID
PR0231906
PE
2361
FACILITY_ID
FA0003776
FACILITY_NAME
KWIK SERV*
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
01
SITE_LOCATION
420 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\K\KETTLEMAN\420\PR0231906\BILLING 1985-2000.PDF
QuestysFileName
BILLING 1985-2000
QuestysRecordDate
5/22/2017 9:57:53 PM
QuestysRecordID
3393275
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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SAN J41¢UI OUNTY PUBLIC HEALTHf-9RV*S <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 HERAN, R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> ogramerne[ e <br /> Record ID Number Program Code and Description Valid <br /> rrmt <br /> PRO51437 PT0010581 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/00 To 12/31/00 <br /> Hazardous Waste Generator Program: <br /> California Health and Safety Code Div.20,Chap.6.5,Art.2-13 Sec.25100 et seq,and Title 22 California Code of Regulations,Chap.20. <br /> PR023190 DERGROUND STORAGE <br /> - -TANK FACILI---- ---TY -- - ----- ---------------------1-11-/-00To 12/31/00 <br /> Underground Stora ram <br /> California Health and Safety Code Div.20,Chap.6.7 and Title 23 California Code of Regulations Chap. 16. <br /> KeCOW 10 remitp i n en s renninbuitus ys m lype LEAK ue= <br /> Active <br /> 2360 13 390002319060508232 PT0009613 10,000 REGULAR UNLEADED Active DOUBLE WALLED INTERSTITAL MONITOR <br /> 2360 14 390002319060508233 PT0009612 8,000 MIDGRADE UNLEADED Active DOUBLE WALLED INTERSTITAL MONITOR <br /> 2360 11 390002319060508230 PT0009611 7,000 MIDGRADE UNLEADED Active DOUBLE WALLED INTERSTITAL MONITOR <br /> 2360 5 390002319060190605 PT0004748 550 NON MVF Active <br /> BOE ID#::44-000074'::... <br /> Underground Storage Tank Per 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. <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 <br /> 18,n well as any conditions established by San Joaquin County. <br /> 3) If the Tank 0pemtor(s)is different from the Tank Owner,m if the Permit to Operate is issued to a person other than the owner or operator of the tank,the <br /> Permittee shall ensure that both the Tank Ownerand 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/ERD)and are considerer) <br /> UST Permit Conditions. Copies of the Procedures and Emergency Response Plan must be attached to this permit or be available for review and/or inspection <br /> 5) "MUrSTttee shall 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 manufacturer,and provide documentation of such servicing to this office. <br /> 7) In the event of a spill,leak,or other unauthorized release,the Pemnitee shall comply with the requirements of 7fi[Ie23CCR,Chap. 16,Art.5,andthe <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 /> fmm 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 changein equipment,design oropemtion of the UST system(including change in tank contents or usage),the Permit to Operate will be subjectto <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: EQUILON LLC ENTERPRISES <br /> Tank Owner: SHELL OIL COMPANY <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: TOKAY SHELL' Facility ID FA0003776 <br /> 420 W KETTLEMAN LN Account ID AR0003356 <br /> LODI, CA 95240 Issued 9128/2000 <br /> 7023.rp1 <br />
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