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<br /> SAN JOAQUI•OUNTY ENVIRONMENTAL HEALTH•D
<br /> 304 E.Weber Ave.,Third Floor mrl
<br /> Suon,CA 95202-2708• Phone EPARi(209)468-3420 FE ED
<br /> Donna Heran,RF-H.S.,Director MAY 0 3 2004
<br /> NVIRONENT
<br /> ENVIRONMENTAL HEALTH PERMIT/SERVICESTH
<br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br /> PERMIT TO OPERATE
<br /> Program Permit
<br /> Record ID Number Program Code and Description Pcrmll
<br /> PRO514283 PT0010486 2220,SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY Valid
<br /> Hazardous Waste Generator Proaram• 1/1/2004 To 12/31/2004
<br /> In order to maintain the permit to operate,Hazardous Waste Generators shall comply With California Health and Safety Code,Div.20,Chap.6.5,Art.2-13,
<br /> Sec.25100 et seq,and Title 22,Califomia Code of Regulations,Chap.20.
<br /> - -
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<br /> PR0231465 2300-UNDERGROUND STORAGE TANK FACILITY
<br /> Underground Storage Tank Prooram• 1/1/2004 To 12/31/2004
<br /> Califomia Health and Safety Code,Div_20,Chap.6.7 and Title 23,California Code of Regulations,Chap. 16.
<br /> F/E 7mrk:/ Tank P.ecord ID Pe.^.r•it# Capacity roe t
<br /> 2360 6 390002314650146506 PT0004485 8,000 PREMIUM UNLEADED Prrm r St tt s S rem Tvp f e k D tett ren
<br /> 2360 5 390002314650146505 PT0004483 10,000 MIDGRADE UNLEADED Actbillable DOUBLE WALLED Continuous Interstitial Monito ing
<br /> 2362 4 390002314650146504 PT0004473 12,000 REGULAR UNLEADED Active, billable DOUBLE WALLED Continuous Interstitial Monitoring
<br /> W'E�1D#: 4`. Active, billable DOUBLE WALLED - Continuous Interstitial Menilonng
<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 maintain the operating pemdq 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
<br /> established by San Joaquin County.
<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 shall ensure that both
<br /> 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 Deparnnent(Et£D)and are considererd UST Permit Conditions. The approved
<br /> monitoring,response,and plot plans shall be maintained onsite with the permit.
<br /> 5) The Permittee shall comply with the monitoring procedures referenced in this pemdL
<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,and
<br /> Provide documentation of such servicing to this office.
<br /> 7) In the event of a spill,leak,or other unauthorized release,the Per litee shall comply with the requirements of Title 23 CCR,Chap.16,Art.5,and the approved Emergency Response 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 was
<br /> performed.
<br /> 9) The EM 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 Operate will be subject to review,modification or
<br /> 11) L yff&&ll An,repair and/or removal permits are required from the EHD prior b 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 date of the issuance of this permit
<br /> 13) This Permit to Operate shall not be considered permission to violate any laws,ordinances or Starnes of any other Federal,State or Local agency.
<br /> 14) A"Conditional'Permit maybe 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: TIME OIL CO
<br /> DBA: JACKPOT FOOD MART(MNTCA)
<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> Regulated Facility FOOD MART' Facility ID FA0003739
<br /> 1434 W YOSEMITE AVE Account ID AR0008444
<br /> MANTECA, CA 95336 Issued 4/112004
<br /> Billing Address:
<br /> %�'ve p�
<br /> 2737 W COMMODORE WAY
<br /> SEATTLE, WA 98199
<br /> 7023.rp1
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