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SAN JOI&)IN COUNTY PUBLIC HEALTHISRVICES <br /> !V <br /> P O Box 388 STocKToN, CA 95201-0358 • Pao 209) 468-3420 <br /> ERNEST M. FUHMOTO, M.D., M.P.H., ACTING HEALTH OFFICER <br /> DONNA RERAN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> attt't1 s+ l IIT FOR L-0JN0 STCRAGE TAM" FACILITY <br /> Tank Tank Permit Annual Permit Fee r"aiid <br /> PiE Number Record i0 Number Capacity Contents Perruit Status Fraft To <br /> 2360 001 TA248201 004324 12,000 Other 01 Active Permit 01101/46 12/31/96 <br /> 2360 002 TA248202 004325 12,000 Unleaded 01 Active Permit 01/01/96 12131/96 <br /> 2;60 003 TA248203 00,!3263 12,000 Unleaded 01 Active Permit. 01/01/96 12/31/96 <br /> PERMIT CONDITIONS : <br /> 1) The PERMIT TO OPERATE will become void if ANNLIAL PERMIT Fees and SERVICE Fees are not Paid and/or the UST system(s) fails <br /> to remain in compliance with the PERMIT CONDITIONS. <br /> 2) The PERMIT TO OPERATE is granted to the TANK OWNER who accepts resFonsibility fey; operating and monitoring the UST system <br /> according to State underground storage tank laws and regulations as well as any conditions established by Sail Joaquin County. <br /> 3) The TANK OPERATOR(S), if different from the tank owner: shall operate and monitor the LIST system according to the WRITTEN <br /> OPERATING AGREEMENT required under Section 25293, Chapter 6.7, Division 20, California Health and Safety Code. <br /> 4) The IP1I4 OWNER still notify the Environmental Health Division of any Proposed change in operation or ownership of the LPST <br /> system. <br /> 6) upon any change in equipment.; design or operation of this facility, the PERMIT TO OPERATE will be reviewed by the <br /> Environmental Health Division. <br /> 6) A construction or removal permit is required from the Environmental Health Division prior to any removal or <br /> change of UST system equipment. <br /> 7) This PERMIT TO OPERATE shall riot be considered permission to violate any existing laws, ordinances or statutes of other <br /> federal, state or local agencies. <br /> PERMIT TO OPERATE an UST FACILITY issued to: CHEVRON USA <br /> 2410 CAMINO RA.MON <br /> SAN RAMON, CA 94583 <br /> PERMIT:= TO OPERATE and ANNUAL PERMIT FEE PAYMENT; are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause . <br /> 11141'w FORM MUST BE ]DISMAYED Cz�ISFICtUUSLY ON THE PREMISES <br /> REGULATED FACILITY, CHEVRON USA INC #260764 Account. 10: 000329:= <br /> 4747 IAE'_T LN Facility IO; 003719 <br /> STOCKTON, CA 95210 Permit Printed: OS/02/96 <br /> BILLING ADDRESS: <br /> CHEVRON USA INC #200764 <br /> ATTN : PERMIT DIE%". <br /> PC] BOX 6004 <br /> ':;AN RAI'O , CA 9.4533 <br />