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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E.Webs Ave.,Third Floor•Stockton,CA 95202-2708•Phone(209)468-3420 Dorms Haan,REH.S.,Director ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE - Pemril Valid Program Permit d Description Record ID Number Program Code an1/1/2002 To 12/3112002 PRO23225 2300-UNDERGROUND STORAGE TANK FACILITY Undemround Storage Tank Program: Califomia Health and Safety Code Div 20 Chap 6 7 and Tille 23 Califomr Codfte of RegulatlPerrut Status System Type Leak Detection P/E Tank# Tank Record ID Perron n p r PREMIUM UNLEADED Condlhonal DOUBLE WALLED Conu it I n anal 2360 7 390002322590225907 11:R5'151 6,000 Mont g d10onal DOUBLE WALLED Can REGULAR UNLEADED continuous Ial Monitoring 2362 6 390002322590225906 PT0004150 6,000 BOE ID#. 44-02499$x:. 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 Pen it Conditions. 2) In order to maintain the Operating Permit,the owner and operator shall comply with the H&S Code,Div.20,Chap.6.7 and 6.75;and CCR Tide 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 tank,the Permittee shall ensure at both the Tank Owner and tank Operator receive a copy of the Permit. 4) Written Monitoring Procedures and an Emergency Response Plan most be approved by the Environmental Health Department(EHD)and are comidererd UST Permit Conditions. The approved monitoring,response,and plot plans shall be maintained onsite with the Permit 5) The Pennines shall comply with the monitoring procedures referenced in this pemdt 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 a spill,leak,or other unauthorized release,the Permitee shall comply with the requirements of Tide 23 CCR Chap.16,Art.5,and the approved Emergency Response Plan. 8) Written records of all 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 monitonng was Performed. 9) The EHD shall be notified of any change in ownership or operation of the UST system vndun 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) Construction,repair and/or removal Permit are required from the EHD prior to any change,repair or removal of UST system equipment 12) The Permittee shall submit an annual report documendng 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,Stale or Local agency. 14) A"Conditional"Permit may be revoked if corrections specified on the inspection report arc not completed by the date(s) indicated- PERMITS ndicated PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: LUKOSE,JOSEPH Tank Owner: PHILIP, MATHEWIJAMES THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Facility ID FA0001457 Regulated Facility. COLLEGEVILLE MARKET&CAFE' Account ID AR0001456 13521 E MARIPOSA RD Issued 3129/2002 STOCKTON. CA 95205 Billing Address: ATTN : PHILIP MATHEW COLLEGEVILLE MARKET&CAFE` 13521 E MARIPOSA RD STOCKTON, CA 95205 7023.rpt