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<br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
<br />304 E. Weber Ave., Third Floor • Stockton, CA 95202-2708 • Phone (209) 468-3420
<br />Donna Heran, R.E.H.S., Director
<br />ENVIRONMENTAL HEALTH
<br />SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br />PERMIT TO OPERATE
<br />Permit
<br />Program Permit Program Code and Description Valid
<br />Record ID Number
<br />DOUS WASTE GENERATOR FACILITY
<br />1/1/2003 To 12/31/2003
<br />PRO521294 PT0014395 2220 - SMALL QUANTITY HAZAR
<br />Hazardous W ste Generator Program:
<br />mia Health and Safe ode, Div. 20, Chap _ 6.5, Art _2-13,_Sec_ 25100 -- ---- -- n-- Title 22, California Code of Regulations, Chap_ 20__
<br />------------------------
<br />--------- -- - - --
<br />1/1/2003 To 12/31/2003
<br />PR0231830 2300 - UNDERGROUND STORAGE TANK FACILITY
<br />'Califomia Health and Sa `Code, Div. 20, Chap. 6.7 and Title 23, Califomia Code -of Regulations, Chap_ 1- - ------------------------------------------
<br />- iv.
<br />Irrc ,,. n . _.... ------- -- UVUr5Lc
<br />2360 5 390002318300183005 PT0006556 1,000 REGULAR UNLEADED Active, bl a e
<br />2362 2 390002318300183002 PT0006548 1,000 REGULAR UNLEADED Active, billable oousLE WALLED Continuous Interstitial Monitoring
<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 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 is, 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 thatboth
<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 Department (EHD) and are cotuidererd UST Permit Conditions. The approved
<br />monitoring, response, and plot plans shall be maintained onsite with the permit.
<br />5) The Pennittee 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 Permitee shall comply with the requirements of Title 23 CCR, Chap. 16, Art 5, and the approved Emergency Response Plan.
<br />spection for a period of at least three years from the date the monitoring was
<br />8) Written records of all monitoring performed shall be maintained on-site by the operator and be available for in
<br />performed.
<br />9) The EHD shall be notified of any change in ownership oroperation 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) WO"n, repair and/or removal permits are required from the ERD 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 anniversary 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 any other Federal, State or Local agency.
<br />14) A "Conditional" Permit may be 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: BOZZANO, LINO
<br />DBA: THREE PALMS GROCERY
<br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br />Regulated Facility: THREE PALMS GROCERY
<br />6732 E WATERLOO
<br />STOCKTON, CA 95215
<br />Billing Address:
<br />THREE PALMS GROCERY
<br />6732 E WATERLOO RD
<br />STOCKTON, CA 95215
<br />7023.rpt
<br />Facility ID FA0004030
<br />Account ID AR0003669
<br />Issued 5/1/2003
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