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� r SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E.Weber Ave.,Third Floor• Stockton,CA 95202-2708• Phone(209)468-3420 Donna Henan,AHH.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 PR023225 2300•UNDERGROUND STORAGE TANK FACILITY 1/112002 To 12/31/2002 Underground Storage Tank Program: California Health and Safety Code Div_20,Chap_6.7 and Title 23 California Code of Regulations Chap_16. ---'- --------- -------' P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection 2360 7 390002322590225907 PT0004151 6,000 PREMIUM UNLEADED Conditional DOUBLE WALLED Continuous Interstitial Monitonog 2362 6 390002322590225906 PT0004150 6,000 REGULAR UNLEADED Conditional DOUBLE WALLED Continuous Interstitial Monitoring Underground Storage Tank Permit Conditions 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. 2) In order to maintain the operating pemdt,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 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 lank,the Permittee 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 Perrot Conditions. The approved monitoring,response,and plot plans shall be maintained onsite with the penrut 5) The Permittee shall comply with the monitoring procedures referenced in this pemut 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 provide documentation of such servicing to this office. 7) In the event of 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. 8) Written records ofail monitoring performed shall be maintained on-site by the operator and be available for inspection for a period of at least three years from the date the monitoring was performed- 9) erformed9) 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 to Operate will be subject to review,modification or revocation. 11) Com uctioq repair and/or removal perms are required from the EHD prior to any change,repair or removal of UST system equipment 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. 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 maybe revoked if corrections specified on the inspection report are not completed by the date(s) indicated- PERMITS ndicatedPERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: LUKOSE,JOSEPH e- Tank Owner: PHILIP, MATHEWIJAMES THIS FORM NTUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Regulated Facility. COLLEGEVILLE MARKET &CAFE' Facility ID FA0001457 13521 E MARIPOSA RD Account ID AR0001456 STOCKTON. CA 95205 Issued 3/2912002 Billing Address: ATTN : PHILIP MATHEW COLLEGEVILLE MARKET&CAFE' 13521 E MARIPOSA RD STOCKTON, CA 95205 7023.rpt