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SAN JOA',UIN COUNTY PUBLIC HEALTH SOICES ll <br /> 304 E.WEBER AVE.,THIRD FLOOR • STOCKTON,CA 95202 • PHONE(209) 468-3420 <br /> KAREN FORST,M.D.,M.P.H., HEALTH OFFICER <br /> DONNA HERRN,R.E.H.S.,DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTPY CERTERMITIFIED <br /> D UNIFIINE PROGRAM AGENCY <br /> Permit <br /> Valid <br /> prem Permit <br /> Record ID ANumber Program Code and Descriptim To 111101 To 12131101 <br /> Underground Storage Tank Pro UNDERGROUND STORAGE TANK FACILITY <br /> PR0231600 z�-,_. <br /> Dram: <br /> Califotmia Hea_It_h_a_nd Safely Code Div,20,Chap,6.1 and Tile 13 California Code of Regulalons Chap.16_________________________________ <br /> Contents pt <br /> Stems System Type Leak Detection <br /> P/E Tank# Tank Record ID Pemut# CapaciTy DIESEL Active DOUBLE WALLED ELECTRNC L LEAK OTEC <br /> 2360 6 390002316000160006 PT0004280 8.000 PREMIUM UNLEADED Active DOUBLE WALLED ELECTRNC L LEAK DTEC <br /> 2360 5 390002316000160005 PT0004285 8,000 DOUBLEWALLED ELECTRNC L LEAK DTEC <br /> 2362 4 390002316000160004 PT0004284 10,000 REGULAR UNLEADED Act <br /> ve <br /> 80E1D#: 44-024781` '' <br /> Underground Storage Tank Permit Conditions <br /> 1) The Permit to Operate wig become void if Annual Permit Fees and Service Fees are not paid and/or the UST system(s)Falb to remain in compliance with these Permit <br /> Conditions. Title 23,Chap.16 and 18,as we as <br /> 2) N order n maintain the operating permit,the permit holder shall comply with the H&S Code,Div.20,Chap.6.7 and 6.75;and CCR, <br /> any conditions established by San Joaquin County. <br /> ll <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 she <br /> ensure that both the Tank Owner and tank Operator receive a copy of the permit. <br /> 4) Written Monitoring procedures and an Emergency Response Plan must be app roved by the Environment al Healthle for rviewanE11D)andaionatt deierd UST Permit <br /> Conditions. Copies of the Procedures and Emergency Response Plan must be attached to this pennit or be available for review and/or inspection at the UST site <br /> 5) The Permittee shall comply with the monitoring procedures referrenced 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 bythe equipment <br /> manufacturer,and provide documentation of such servicing to this office. <br /> 7) in the event of a spill,leak,or other unauthorized release,the Per miwe shag 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 onsite by the operator and be available for inspection fora period of at least three years 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 of the UST system(including change in tank contents or usage),the Permit to Opmte 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 Purittee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the anniversary date oflhe issuance ofthis 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: CALIFORNIA FUEL STOPS INC <br /> Tank Owner: FUEL STOPS LAND &DEVEL LLC <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facility ID FA0000957 <br /> Regulated Facilit TIGER EXPRESS#3' Account ID AR0000954 <br /> "14800 S Issued 312912001 <br /> MA. CA@&ANTEC5336 <br /> Billing Address: ATTN : CALIFORNIA FUEL STOPS INC <br /> CALIFORNIA FUEL STOPS INC <br /> PO BOX 1207 <br /> STOCKTON, CA 95201 <br /> 7023.rpt <br />