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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPAF4Wff 304 E. Webs Ave., Third Floor • Stockton, CA 9520,2..Mg • P1101160111IM68111111102D Donna Haw, R.EH.S., Director ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE Program Permit Permit Record ID Number Program Code and Description Valid PRO23183 2300 - UNDERGROUND STORAGE TANK FACILITY 1/1/2002 To 1213112002 Underground Storage Tank Prooram: r-nflinmin Health and Safatv Code Div. 20. Chao. 6.7 and Tide 23 California Code of Regulations Chap_ 16 ---------------------------------- 2360 5 39000LSIBJUU1WUU0 riuvuuQUQ Monitoring 2362 2 390002318300183002 PT0006548 1,000 REGULAR UNLEADED Active, billable DouetE WALLED ce Continuous lnterslival Mous Inng Underground Storage Tank Permit Conditions I) The Permit to Operate will become void if Annual Permit Fees and Service Fees are not paid and/or the UST system(s) fails m remain in compliance with these Permit Conditions. 2) In order to maintain the operating pemd4 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 esmblabed by San Joaquin County. 3) If the Tank Operator(s) is different from the Tank Owner, or ifthe Permit to Operate is issued to a person other than the owner or operator ofthe tank, the Pernittee 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 must 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 the permit 5), The Pemtittee shall comply with the monitoring procedures referenced in this permit 6) The retrainee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually, or more frequently if specified by the equipment manufacturer, and provide documentation ofsuch 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, Art. 5, and the approved Emergency Response Plan. 9) Written records ofall 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 EHD 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 m Operate will be subject to review, modification or revocation. 11) Construction, repair and/or removal permits are required from the EHD prior to any change, repair or removal of UST system equipment 12) The Permittee shall submit an annual report documenfing compliance with the UST Permit Conditions within 30 days ofthe anniversary date ofthe issuance of this 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 ifcorections 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. PERMIT(s) Valid only for: BOZZANO, LINO DBA: THREE PALMS GROCERY THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Regulated Facility. THREE PALMS GROCERY* 6732 E HWY 88 STOCKTON.CA 95215 Billin9Address: ATTN : BOZZANO, LINO THREE PALMS GROCERY' 2891 N ARATA RD STOCKTON, CA 95205 7023.rpt Facility ID FA0004030 Account ID AR0003669 Issued 3/2912002