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SAN JOA9JUIN COUNTY PUBLIC HEALTH 9ivaVICES 304 E. WEBER AVE., THIRD FLOOR • STOCKTON, CA 95202 • PHONE (209) 468-3420 KAREN FURST, M.D., M.P.H., HEALTH OFFICER DONNA RERAN, R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE Program Permit Permit u—,.tm Number Program Code and Description Valid PR0231830 2300 - UNDERGROUND STORAGE TANK FACILITY 1/1/01 To 12/31/01 Underground Storage Tank Program: California Health and Safety Code Div. 20, Chap, 6.7 and Title 23 Califomia Code of Regulations Chap_16-------------------------- _ ------ 2362 _____ 2362 2 390002318300183002 PT0006548 1,000 UNLEADED Active Underground Storage Tank Permit Conditions 1) The Permit to Operate win become void if Annual Permit Fees and Service Fees are not paid and/or the USC systems) fails t0 remain in compliance with these Permit Conditions. 2) In order In maintain the operating permit, the permit holder shall comply with the H&S Code, Div. 20, Chap. 6.7 and 6.75; and CCR, Title 23, Chap. 16 and 18, a weft as any wnditions established by San Joaquin County. 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 Permitteeshag ensure that both the Tank Owner and tank Operator receive a copy ofthe permit - 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Environmental Health Division (PHS/EHD) andam considererd UST Permit Conditions. Copia of the Procedures and Emergency Response Plan must be attached to this permit or be available for review and/or inspection at the UST site. 5) The Permittee shall comply with the monitoring procedures refer need in this permit. 6) The Permitter shall perform testing and preventive maintenance on all leak detection monitoring equipment annually, or more frequently if specified bythe equipment manu facturer, and provide documentation ofsuch servicing to this office. 7) In the event of a spill, leak or other unauthorized release, the Perr itee shag complywith the requirements of Title 23 CCR, Chap. 16, Art. 5, and the approved Emergency Response Plan. 8) Wrium records of all monitoring performed shag be maintained on-site by the operator and be available for inspection fora period of at least three years from the date the monitoring was performed. 9) The PHS/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 ofthe UST system (including change in tank contents or usage), the Permit to Operate will be subject to review, modification or revocation. 11) Construction, repair and/or removal permits are required from the PHS/EHD prior to any change, repair or removal of UST system equipment. 12) The Pertrtttee shall submit an annual report documenting compliance with the U SC Permit Conditions within 30 days of tie anniversary date ofthe issuance ofthis 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 if corrections specified on the inspection report are not completed by the dates) indicated. PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s) Valid only for: BOZZANCJ, LINU 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 Billing Address: ATTN : BOZZANO, LINO THREE PALMS GROCERY" 2891 N ARATA RD STOCKTON, CA 95205 7023. rpt Facility ID FA0004030 Account ID AR0003669 Issued 3/29/2001