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r <br /> R <br /> t <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL.HEALTH DEPARTMENT <br /> 304 E.Weber Ave.,Third Floor•Stockton,CA 95202-2708• Phone(209)468-3420 <br /> Donna Henan,RE.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> Program Permit Permit <br /> Record ED Number Program Code and Description Valid <br /> FIR 23122" 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/2002 To 12/31/2002 <br /> Underground Storage Tank Proaram' <br /> California Health and Safety Code Div.20,Chap,6.7 and Title 23 California Code of Regulations Chap_16. _ _____ ----------------- --------------------------- <br /> ---- ' -------- ------- -------- --------- <br /> PIE Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type <br /> 2360 7 390002312270505681 PT0008256 12,000 REGULAR UNLEADED Active,billable DOUBLE WALLED continuous Interstitial <br /> Monitoring <br /> 2360 6 390002312270505680 PT0008225 12,000 REGULAR UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial <br /> Monitoring <br /> 2362 5 390002312270505679 PT0008224 12,000 REGULAR UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial <br /> Monitonng <br /> 130E1D#:�44-023594' "I <br /> Underground Storage Tank Permit 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 these Permit Conditions. <br /> 2) In order to maimmin the operating perms,the owner and operator 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 <br /> conditions established by San Joaquin County. <br /> 3) If the Tank Operamr(s)is different from the Tank Owner,or if the Pennit to Operate is issued to a person other than the owner or operator of the tank,the Permittee shall ensure that <br /> 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 approved by the Environmental Health Department(EHD)and are considererd UST Permit Conditions. The <br /> approved monitoring,response,and plot plans shall be maintained onsite with the pemut. <br /> 5) The Permittee shall comply with the monitoring procedures referenced in this pennit <br /> 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, <br /> and provide documentation of such servicing to this once. <br /> 7) In the event of a spill,leak,or other unauthorized release,the Permilee shall comply with the requirements of Title 23 CCR Chap.16,An.5,and the approved Emergency Response <br /> 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 from the date the monitoring <br /> was performed. <br /> 9) The EHD shall be notified of goy 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 Operate will be subject to review,modification or <br /> revocation. <br /> 11) Construction,repair and/or removal permits are required from the RHO 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 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 dates) indicated. <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: TOSCO NORTHWEST CO <br /> DBA: CIRCLE K STORES <br /> Tank Owner: CIRCLE K STORES INC <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: CIRCLE K STORES INC#5449" Facility ID FA0004033 <br /> 7647 PACIFIC AVE Account ID AR0003673 <br /> STOCKTON. CA 95207 Issued 3/29/2002 <br /> Billing Address: ATTN : LICENSING DEPT DC36 <br /> TOSCO NORTHWEST CO <br /> PO BOX 52085 <br /> PHOENIX,AZ 85072-2085 <br /> 7023.rp1 <br />