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SAN ,VQUIN COUNTY PUBLIC HEALSERVICES <br /> P O Box • S OCKTON, CA 95201.0 • E (209) 465-3420 <br /> ERNEST M. FUHMOTO, M.D., M.P.H., ACTING HEALTH OFFICER <br /> DONNA RERAN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> L)'ERATING PERMIT FOR UNDERGRWND STOW3E rr414a — ' <br /> Tank Tank Permit. Annual Permit Fee ' ...:.: <br /> P.'E Number Record ID _ tknberCapacity Contents Permit Status From To <br /> =330 0011 TAi6'3801 006847 2,000 I ad ed Of Active ermi 17ti 12.: .. <br /> 2i6J OQ:s TA1696J3 006851 100 unleaded 01 Active Permit 01/iali95 12131,';5 <br /> 1300 004 TAl6'3^G4 061854 100 Unleaded 01 Active Permit 011/011/95 12/3if95 <br /> 13w (k�5 TA16` 7S u0685C, iCA Unleaded Of Active Permit 01/01/95 12!31/95 <br /> 23�* 0% TA16'3806 OObS59 100 Unleaded Un <br /> l Active Permit 01iG,./i5 12/31/95 <br /> 2x,30 002 TA169302 007629 2:000 Unleaded 01 Active Permit 01101/% 12!'11;55 <br /> 80 O07 Tp16 01 00783,0 100 Unleaded O1 Active Permit 01/01!95 12/31/95 <br /> 2380 008 TA16Wi? (1078311 100 Unleaded O1 Active Permit 01/01/135 12/31/95 <br /> PERMIT CONDITIONS: <br /> D The PERMIT TO OPERATE will become void if ANNUAL PERMIT Fens and SERVICE Fees are not paid and/or the UST system(s) fails <br /> to remain in compliance with the PERMIT COi1DITION.S. <br /> 2) The PERMIT TO OPERATE is granted to the TANK OWNER who accepts responsibility for operating and monitoring the UST system <br /> according to State underground storage tarok laws and regulations as well as any conditions established by San :Joaquin Cumty <br /> 3) The TANK OPERATOR(S), if different from the tank owner, shall operate and monitor the ITST system according to the WRITTEN <br /> OPERATING AGREEMENT required under Section 25293, Chapter 6.7, Division 20, California Health .and Safety Code. <br /> 4) The TAW OWNER shall notify the Enuiroru?ental Health Division of any Proposed change in operation or !nv??ership of the tFi( <br /> cv=te'm. <br /> 5) Upon any change in equipment, design or operation of this facility, the PERMIT TO CORATE will be reviewed tv tre <br /> Environmental 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 /> ?) This PERMIT TO OPERATE shall not he considered permission to violate any existing laws, ordinances or statutes of other <br /> federal, state or local agencies. <br /> PERMIT TO AERATE an UST FACILITY issued to: DEFT DF THE YOU FH A'-JTH0'RITY <br /> 4'_4.1 WILLIAMSBOURGH OR <br /> ;ACRAr7ENTO, C:A <br /> PERMITS TO OPERATE: and ANNUAL PERMIT FEE PAYMENT'S are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause . <br /> T14IS FO MUST EN--- DISPLAYED C[ FIC(AWSL-y ON THE PREMISE'S <br /> REGULATED FACILITY: NORTHERN CAL YOUTH CENTER Account 10: <br /> 7h-SO S NEWCASTLE RD <br /> STOCKTON CA 9521 = Permit <br /> ID, 0�1 <br /> - mit Frinsedt C?; ! 1 <br /> BILLING ADDRESS; <br /> DEPT OF THE YOUTH Ali T Hi�i=%I TY <br /> 4241 WILLIAMSBOURGH DR <br /> SACRAMENTO, CA <br />