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SAN jogNjIN COUNTY PUBLIC HEALTHRVICES <br /> P O Box 388 W S MKTON, CA 95201-0388 • PHO 209) 468-3420 <br /> ~� ERNEST M. FU3IMOTO, M.D., M.P.H., ACTING HEALTH OFFICER <br /> DONNA HERRN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br /> ENV MONWNTAL BE.LTx <br /> AMENDED FFRMTT <br /> Qf4) 1% r-EEiiMIT Et tjWE R&c11-. STC—GAGE FACILITY <br /> Annual Permit Fee Valid <br /> Tank Tarn Permit. <br /> To <br /> P1E Number Record ID Nu��taer rapacity Contents Permit •stat• Frc=� <br /> 'Vw j 001 TA2S7301 MASTS 350 01 Active Permit C41iv11'G lZ�ull` <br /> PERMIT CONDITIONS: <br /> 1) The PERMIT TO OPERATE will become void if ANNUAL PERMIT Fees and SERVICE Fees are not paid and/or the UE-3T systemr <br /> s? fails <br /> to remain in coppliance with the PERMIT C•ONOTTI;ONy. <br /> 1:� The PEFuM1T TO OPERATE is granted to tete TAS: f dER w�o. accepts responsibility for n�eratina and monit-orirtg the UST syster,, <br /> according to State unotergr ut?d st.crage tangy laws and regulations as well as any conditions established by Safi _�oaguirt C=aunty. <br /> 3) The TANS OPERATOR(S), if different fraft the tanl: owner, shall operate and monitor the UST system according to the WRITTEN <br /> OPERATING AGREEMENT required under Section 2IS233. Chapter 6.7, Division zo, C-alifi rnia '4ealth and Safety Code. <br /> 4) The TANK 0W01 sh-,jll n;ntify the Environp-jental Health Division of any proposed crsanse in operation or ownership ,,f the UST <br /> system. <br /> 5) i. c=n any change it equipment, design or c{oerat.ion of this facility, the PERMIT TO OPERATE will be reviewed by t, <br /> Environmental health Division. <br /> G? A construction or rearJva] f-armit is re�iuired frf=i the Environmental Health division Fri'-Jrtoarty removal of <br /> change of UST system ewiPWt. <br /> permission tc= violate any existing laws; ordinances or statutes of other <br /> 7) T1-ds PERMIT TO OPERATE shall not be considered <br /> federal, state Or local agencies. <br /> PERMIT TO OPERATE an UST FACILITY issued tot ORCHARD :S:'fPPLY H0RD;,aJhF.E CCIRF, <br /> PO ftt=EX 49-0 4 <br /> SAN JCI'--;E, CA 9S! 11 <br /> PERMITS TO OPERATE and ANNJAL,. PERMIT EEE PAYMENTS are NOT TRANSFERABLE <br /> a.nd Friary be; SUSPENDED or REVOKED for cause . <br /> # g + � �: <br /> TprIi–ptAyE C$�I �. �' C 'THE PREMISES <br /> REGULATED FACILIP(. ORCHARD °S;t JFF'LY HAFN,D1 BARE Account 10t 000:--4S49 <br /> 2650 MAC;ARTHk R OR Facility ID; 00:p 941 <br /> TRACY , CSA _-S' 7 G Ferritit. Printe-T 0S i i f°S+F, <br /> BILLINGS ADDRESS; ORCHARD �r C1-RPsORCHARD •._�_i�-F��' HARDkIA E <br /> ATTN t ORCHARD 'S t.JPPLY ACCOUNTING <br /> Ri t FtOX 490,224 <br />