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SAN JOAQUIN i;OUNTY ENVIRONMENIF•AL HEALTH DEPARTMENT 304 E. Weber Ave., Third Floor • Stockton, CA 95202-2708 • Phone (209) 468-3420 Donna Horan, ILE.H.S., Director F9WU N1CRONMEIJI'AL HEALTH SAN J AQU N CO NTY CERTIFI D UNIFIED PROGRAM AGENCY PERMIT TO OPERATE Program Permit Record ID Number Program Code and Description Permit Valid PR0231595 oora -UNDERGROUND STORAGE TANK FACILITY 1/1/2004 To 12/31/2004 �d_el8rou0Q Storage Tank Prooram, California Health and Safety Code, Div. 20, ChapChap,. 6.7 and Title 23, California Code of Regulatlons, Ch: 16. --_--- • us imou n ex momonng 2360 5 390002315950515638 PT0012027 5,000 PREMIUM UNLEADED Active, billable DOUBLE WALLED Continuous Interstitial Monitoring 2362 4 390002315950515637 PT0012026 10,000 REGULARUNLEADEDActive, billable DOUBLE WALLED Continuous Interstitial Monitoring Underground Storage Tank Permit Conditions 1) The Permit to Operate will become void iFAnnual 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 pemrit, 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 Operators) 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 Most 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 die permit. 5) The Permittee shall comply with the monitoring procedures referenced in this permit. 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually, or more frequently ifspecifined by the equipment manufacturer, and provide documentation of such servicing to this office. 7) In the event ofa spill, leak, or other unauthorized release, the Permitee shall comply with the requirements of Title 23 CCR, Chap. 16, An. 5, and the approved Emergency Response Plan. 8) Written records Odell monitoring performed shall be maintained on-site by the operator and be available for inspection for a period ofat least three years from the date the monitoring was performed. 9) The ERD 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 perdis are required from [be EHD prior to any change, repair or removal of UST system equipment. 121 The Permittee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the date of the issuance of (his 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 ifcorrections 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. r �rxrvu I tits) vdnV_,unly tor: SINtiH, AMAKJI I DBA: LINDEN MARKET THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES--` Regulated Facility. L Facility ID FA0003591 8203 E HWY 26 Account ID AR0003169 ST 7 ON, CA 95206 � � Issued 4120/2004 Billing Address: ATTN : GH LINDEN PIARKET* 1708 PLEASANT DR HERCULES, CA 94547 7023 rpt