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l r , SAN JO*U*OUNTY PUBLIC HEALTIOROES 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 OPERATE ogram errmt Permit RecordlD Number Program Code and Description Valid PRO51629 PT0011206 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/00 To 12/31100 Hazardous Waste Generator Program: Califomia Health and Safety Code Div.20,Chap.6.5,Art.2-13 Sec.25100 at seq,and Title 22 California Code of Regulations,Chap.20. ---- ------- ---- - --- --- -- ------- - ------------- --- - ------------------1 -- -- -- - - PR050697 PT0009154 2234-HAZARDOUS WASTE CESW FACILITY 1/1/00 To 12131100 Tiered Permit On-Site Hazardous Waste Treatment Program: California Health and Safety Code Div.20,Chap,6.5,Art.9,and Title 22 California Code of Regulations,Chap.20. - -- - -- --- -- - - - - - - - - - -- ------ -------—--------- ----— -—----------------------------- - PR023144 2300DERGROUND STORAGE TANK FACILITY 1/1/00 To 12/31/00 Underground Storage Tank Progra California Health and Safety Code Div.20,Chap.6.7 and Title 23 California Code of Regulations Chap. 16. - ---------- - - - - - -- --- - - ------ ---------- - ------- ------ - - -- - - - --- - -- - ---- ---------------- an Recordremit Capacity PermitStatus Active Underground Storage Tank Permit Conditions I) The Permit to Operate wil I 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 and 18,as well as any conditions established by San Joaquin County. 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 ensure that both the Tank Owner and tank Operator receive a copy of the permit. 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Environmental Health Division(PHS/Eli and are considererd UST Permit Conditions. Copies of the Procedures and Emergency Response Plan must be attxhed to this permit or be available for review and/or inspection 5) 1th UST site. }ne permittee shall comply with the monitoring procedures referrenced in this permit. 6) The Permittee shall perform testing and preventive maintenance on all leak detection 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 spill,leak,or other unauthorized release,the Pennitee shall comply with the requirements of Title 23 CCR,Chap. 16,Art.5,and the approved Emergency Response Plan. 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 from the date the monitoring was performed. 9) The PHS/EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change. 10) Upon any change in equipment,design or operation of the UST system(including change in tank contents or usage),the Permit to Operate will be subject to review,modification or revocation. 11) Construction,repair and/or removal permits are required from the PHS/EHD prior to any change,repair or removal of UST system equipment. 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 of this permit. 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. 14) A"Conditional'Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: DOCTORS HOSPITAL OF MANTECA THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Regulated Facility: DOCTORS HOSPITAL OF MANTECA Facility ID FA0000853 1205 E NORTH ST Account ID AR0000851 MANTECA, CA 95336 Issued 9/2812000 Billing Address: ATTN : DRS HOSP OF MANTECA/ACCTS PAY DOCTORS HOSPITAL OF MANTECA 1400 FLORIDA AVE STE 204 MODESTO, CA 95350 7023.rpi