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l_ ENORONMENTAL HEALTH POST ON PREMISE <br /> PERMIT N0. <br /> ISSUED: EXPIRES: <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> n._ ENVIRONMENTAL HEALTH DIVISION <br /> 122, 17" - _ - 1601 E. HAZELTON AVE. • PHONE 468-3420 <br /> Permit issued to: P.O.BOX 2009 • STOCKTON,CA 95201 <br /> ? t HnTM'tldT-iaTY <br /> 22 E. <br /> M' — ' TREET OPERATING PERMIT FOR UNDERGROUND <br /> !It,K IN c.N r"`"=202 <br /> STORAGE TANK FACILITY <br /> +et'.i5i U_ M No! FOLT' '-- <br /> TANK OWNER <br /> SAM PACHUK:A ;iY OF =;f0:i <br /> 425 N. EI DORADO :TREE T ^;r, N. EL DORADO ., <br /> HOCIKTON C-F-1 950011jN CA 95120i <br /> NUMBER OF TANKS <br /> Tank De5ir3Ption PrOduct :nr c,C1=:Y LDM `i to tu5 <br /> 0001 TAM.-*"S ---- Motor Ve;dcle ;uei F,i_ ?f? 02 <br /> 002 TANK_' Motor Vehicle Fuel 1i,;Oi?I 8U< <br /> 00 TANKS Motor Vehicle Fuel 4,t)tji, 0.5 C?2 <br /> CONDITIONS <br /> 1. This permit expires on December 31, of the current year. Inspection fee will be billed annually. <br /> 2. This permit is granted to the tank owner who accepts responsibility for operating and monitoring the tank <br /> system according to state underground storage tank laws and regulations and conditions set by the county. <br /> 3. Tank operators, if different than the owner, shall operate and monitor the tank system according to the <br /> written operating agreement required under Section 25293, Chapter 6.7, Division 20, California Health and <br /> Safety Code. <br /> 4. Tank owner shall notify the Environmental Health Division of any proposed change in operator or ownership <br /> of tank system. <br /> 5. Upon a significant change in design or operation of this facility, permit will be reviewed by the <br /> Environmental Health Division. <br /> 6. This permit cannot be considered as permission to violate existing laws, ordinances, regulations or statutes <br /> of other governmental agencies. <br /> 'hi=. is R COYv-it.i Oiel Periiiitsubject In Slt3Pe?15.01-1 or reVol;ati Cri' Oi= tel i!_are tF.,_ . <br /> . t`rP diCrla{.10115 Fiv the CCtijlPlid.l'Ce date(5) doted on the n)cs+ reCerVt. IX-iST fa.ciltt.Y <br /> report.. <br /> Jogi Khanna, M.D., MPH Ronoti,REHS, Director <br /> Health Officer NON-TRANSFERRABLE Envoental Health Division <br /> THIS PERMIT MAY BE SUSPENDED OR REVOKED FOR CAUSE <br />