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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E.Weber Ave.,"Third Floor• Stockton,CA 95202-2708•Phone(209)468-3420 Donna Heron,RE.H.S.,Director �1�MEIHEALTH SAN J IN IE TY ERTIFUNIFIED PROGRAM AGENCY PERMIT TO OPERATE Permit Program Permit Valid Record ID Number Program Code and Description PR0507164 2300-UNDERGROUND STORAGE TANK FACILITY 11112003 To 1213112003 Underground Storage Tank Program: California H_ealth and_ Safety Code,Di----- Chap,6.7 and TiOe 23,California Code of Regulations,Chap, --- ---- ------ .--- --- -_--- ------------- ---- - - - --- - Leak Detection P/E Tank p Tank Record ID Permit# Capacity Contents Penni[Status DOUBLE WALLED Continuous Interstitial Monitoring 2360 6 390005071640515588 PT0011563 6,000 DIESEL Active,billable PREMIUM UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial Monitoring 2360 5 390005071640515587 PT0011561 9,000 REGULAR UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial Monitoring 2362 4 390005071640515586 PT0011561 15,000 Underground Storage Tank Permit Conditions 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. 2) In order to maintain the operating permit,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 conditions established by San Joaquin County. 3) If the Tank Operator(s)is ditferenl 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 Lank Operator receive a copy of the permit. 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 approved monitoring,response,and plot plans shall be maintained onsite with the perrrtit 5) The Pemtittee shall comply with the monitoring procedures referenced in this pemtiL 6) The Pemiittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently ifspecified by the equipment manufacturer,and provide documentation of such servicing to this office. 7) In the event of a spill,leak,or other unauthorimd release,the Pennime shall comply with the requirements of Title 23 CCR Chap.16,Art.5,and the approved Emergency Response Plan. g) 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 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 11) Cq&%4ILQIbn,repair and/or removal pennies are required from the EHD prior to any change,repair or rennval 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 maybe revoked if corections specified on the inspection report are not completed by the dau(s) indicated. PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: ORLANDO, SAMUEL BENJAMIN DBA: ORLANDO'S#5 Tank Owner: ORLANDO, SAM B THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Facility ID FAB007722 Regulated Fadlitg ORLANDO'S#3 Aaount ID AR0013418 18754 E HWY 26 Issued 511/2003 LINDEN, CA 95236 Billing Address: ORLANDO'S #3 PO BOX 1500 LINDEN, CA 95236 7023 rpt