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<br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 304 E.Wehcr Ave.,'Third Floor•Stockton,CA 95202-2708• Phone(209)468-3420
<br /> Donna Heran,REH.S.,Director
<br /> ENVIRONMENTAL HEALTH
<br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br /> PERMIT TO OPERATE
<br /> Program Permit
<br /> Record ID Number Program Code and Description Permit
<br /> PRO514283 P 01048 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY Valid
<br /> Hazardous Waste Generator Program, 1/1/2004 To 12131/2004
<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 /> Se-c.-.2510 at Beq,and Title 22,California Code of Regulations,Chap.20_
<br /> PR0231465 2300-UNDERGROUND STORAGE TANK FACILITY
<br /> Underground Storage Tank Program- 1/1/2004 To 12/31/2004
<br /> Califomia Health and Safety Code,Div.20,Cha _6.7 and Titie 23,Califomia Code of Regulations,Chet , 16_
<br /> ----------------- -- --------- ------- -----P
<br /> . .... ....... -----P
<br /> P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status S stem Type
<br /> 2360 6 390002314650146506 PT0004485 8,000 PREMIUM UNLEADED y Leak Detection
<br /> 2360 5 390002314650146505 PT0004483 10,000 MIDGRADE UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial Monitoring
<br /> 2362 4 390002314650146504 PT0004473 12,000 REGULAR UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial Monitoring
<br /> BOE D#:.44-014379 �f .C: Active,billable DOUBLE WALLED Continuous Interstitial monitoring
<br /> Underground Storage Tank Permit Conditions
<br /> I) The Permit to Operate will became 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 permit,the owner and operator shall comply with the H&S Code,Div.20,Chap.6.7 and 6.73;and CCR,Tide 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 most be approved by the EmironmemoT Health Department(EHD)and are considemad 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 permit.
<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 Permium 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 EHD shall be notified of any change in ownership or operation of the UST system withm 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) CtYKf8 Mn.repair and/or removal permits are required from the EHD 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 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 my 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 JACKPOT FOOD MART* Facility ID FA0003739
<br /> 1434 IN YOSEMITE AVE Account ID AR0008444
<br /> MANTECA, CA 95336 Issued 4/1/2004
<br /> Billing Address:
<br /> JACKPOT FOOD MART*
<br /> 2737 W COMMODORE WAY
<br /> SEATTLE, WA 98199
<br /> 7023.rpt
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