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SAN J04 UIN COUNTY PUBLIC HEALTBMRVICES
<br /> P 0 Box 388 Sj)Dc-wjw, CA 95201-0388 0 -3420
<br /> pHOW(209) 468
<br /> ERNEST M. FUJIMOTO, M.D., M.P.H., ACTING HEALTH OFFICER
<br /> DONNA RERAN, R.F.H.S., DIRECTOR., ENVIRONMENTAL HEALTH DIVISION
<br /> EIN"LONMENTAL BEALTH
<br /> DRAGE TANK FACILITY
<br /> WERAT I NG n kR ky,�MRGROUND STO
<br /> L F"IT FL
<br /> Annual Permit Fe-i
<br /> Tank. Taf� Perroit I
<br /> ty Cxntents Perf-A-1t. St.-Rt-US From C,
<br /> L.-,rd El tjLmher CaP�a�ci- �Z�)
<br /> 5 21 C t)n d i t e T10 i-t
<br /> 2380 00c. 004150 NO ur-lead�j (11110 i? 11
<br /> corditional PETnlit 12P,
<br /> TA.221-�307
<br /> PERMIT COND'ITION'S: Lem.
<br /> -s and SERVICE Fees are not paid and/or thc- 1G-,T sYs' fs) i�i-
<br /> beco4e void if ANWk PERMIT Fees The KERl' ,.JT
<br /> T M CIPERPAJIL: will E
<br /> to Temaj-11 iq L I th UST sysi.&I
<br /> cot4pl;ance tg:t�j the PERMIT CCM51TI'T.6. rep's responsibility fnp opr--P=I;Tq and ganitorino e
<br /> 71 N PERMIT To OPERATE is granted .c. the TAW, W-Uh who ac. 4
<br /> well as any conditions est�tlish--d by U11
<br /> accc,rdin-4 tc, State urplergound storage '30. lav's and requlatic"Is as T
<br /> c 11 operate and winritc-r- tie UU s-i5teyp, :ll:cn?din9 t.c, 10R I
<br /> t. tark owner, shall The TAW 0PERATOR(SI; if differeilt fr,,Xo
<br /> n 14(1, California P-ealth and orfCueCFERATING AGREEMENT r-aquired un6er 0-,ectiu 25293, Chapter 6.7, givisio, r-se - qe in A -n ocwihip e-T the UVT
<br /> y t?le
<br /> nig )-ipalth Division :if anq pro,-, d &�an-
<br /> 4" The 16 ANK 014NER shall notify
<br /> syster-,. RMIT To ,"ipERA
<br /> ipffent, design or operatioll of th" f,- I I
<br /> .5) Uptin any �hane JP M the PEN TE will tie Tevic--W-01 by ! e
<br /> Envilronwie-11tal any rer�!-V�l rif
<br /> I I -
<br /> 63 A ccinstruction ,r rMovaj permit is required from th,- Envivorriental health Divis-on PFiL)r P
<br /> chame of 1.$T systetn equiment. jt.e ally e�,istiT�g laws, ordi
<br /> SL-11 not be ion-nidered perfftissicll-t t-0 viol kances c--, std,�--tes Of cl
<br /> 7) T11-dr, PERMIT T9 GPERATEk
<br /> 1q.1
<br /> fe-deral: state Or l0c?', Bgf--nc ies
<br /> S Are not En-,T.r,-Ieted by N d�-,-e(5) spec if ied c-;i i
<br /> ed if cor�PecfiOfi
<br /> 8) A lTond-j,io-jjaj perwi-it" ffiay be revc-*.
<br /> #
<br /> PERMIT T111 DMATE an irST FACILILITf issued bD
<br /> 1LLE. h 1AFii- E a a, C: SFE
<br /> RD
<br /> 0TOC,KTON, CA
<br /> PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENT, av-e NOT TRANSFERABLE
<br /> and may be SUSPENDED or REVU;1D for catlse .
<br /> L
<br /> SpLAyED CMM I
<br /> ,p (-ijjxP
<br /> , Y ON THE PRF—MISE
<br /> S
<br /> 'THISP Flk-gn "- -.rST BE DI
<br /> C 1- EVILLE C:A F E To�
<br /> RECWTU0 FX-1!7,� LEG 14.5 7
<br /> 11ARI--O!-!a RD
<br /> 0 `TON , CA '74 5'20 5
<br /> C1 Perwlit PriTfted:
<br /> %4
<br /> BTL!1AMRE`6'DI
<br /> Li
<br /> COLLEG'E"VILLE MAR�-*.ET CAFE
<br /> AF--
<br /> R["--T I
<br /> ATTN � COLLEGEVILLE NA
<br /> 1'::-';21 E MAF.IPF-16A RD
<br /> -.-;TOiC:KTC;fid, CA' 9-52"O's
<br />
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