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r� i�� <br /> SAN JOIN COUNTY PUBLIC HEALTH &ICES <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 RERAN,R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> Permit <br /> Program permit Program Code andlkscriptim Valid <br /> Record ID Number 1/1/01 To 12/31/01 <br /> PRO516298 FT 0011206 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY <br /> Hazardous Waste Generator Procram: <br /> Califomia Health and ode_Div.20,Chap_6.5e Art_2-13 Sec.25100 et seq,and TiBe 22 Califomia Code of Regulations,Chap.20------- ------ <br /> PR0231446 UNDERGROUND STORAGE TANK FACILITY <br /> ------ 111101 To 12/31/01 <br /> Underground Stora a Tank <br /> Califomia Health and Safety Code_ iv_20,Chap.6.7 and TIOe 23 Califomia Code of Regulations Chap_16----------------.-___-__--__----__ <br /> P/E Tank# Tank Record ID Permit# Capacity Contents Pcnnit StaNs <br /> 2362 2 390.002314460144602 PT0004154 550 DIESEL Active <br /> Underground Storage Tank Permit Conditions <br /> 1) The Perat to Operate will become void if Annual Permit Fees and Service Fees are not paid and/or the UST sysrem(s)fails toremain in compliance withthese Permit <br /> Conditions. <br /> 2) In order to maintainthe operating permit,the permit holder shall oomplywith the H&S Code,Div.20,Chap.6.7 and6.75;and CCR,Title 23,Chap.16 and 18,as well as <br /> any conditions established by San Joaquin County. <br /> 3) if the Tank Operator(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 Permittee shall <br /> ensure that both the Tank Owner and tank Operabr Twelve a copy of the permit. <br /> 4) Writan Monitoring Procedures and an Emergency Response Planmust be approved by the Environmental Health Division(PHS/EHD)and are considererd USTPermit <br /> Conditions. Copies of the Procedures and Emergency Response Plan must be attached tothis peat or be available for review and/or inspection at the USC site. <br /> 5) The Pemtittee shall comply with the monitoring procedures referenced in this permit. <br /> 6) The Per trainee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or mom frequently if 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 unauthorised release,the Pemitm shall comply with the requirements of Title 23 CCR,Chap.16,Art.5,and the approved Emergency <br /> Response Plan. <br /> 8) Written records of all monitoring performed shag be maintained on-site bythe operatorand be available for inspection fora period of at least three}ears from the date the <br /> 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 change 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 Permitter shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the anniversary date of the issuance 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 /> PERMFTS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: DOCTORS HOSPITAL OF MANTECA <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facility ID FA0000853 <br /> Regulated Facility: DOCTORS HOSPITAL OF MANTECA Acoount ID AR0000851 <br /> 1205 E NORTH ST Issued 3/2912001 <br /> MANTECA. CA 95336 <br /> Billing Address: ATTN : DRS HOSP OF MANTECA/ACCTS PAY <br /> DOCTORS HOSPITAL OF MANTECA <br /> 1400 FLORIDA AVE STE 204 <br /> MODESTO, CA 95350 <br /> 7023.rp1 10 1 I <br />