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SAN JO� JIN COUNTY PUBLIC HEALTH WICES <br /> 304 E.WEBER AVE., THIRD FLOOR • STOCKTON,CA 95202 • PHONE(209) 468-3420 <br /> KAREN FURST, M.D., M.P.H., HEALTH OFFICER <br /> DONNA RERAN, R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> rogram Permit Permit <br /> Record ID Number Program Code and Description Valid <br /> PR023133 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/00 To 12/31/00 <br /> Underground Storage Tank Program: <br /> California Health and Safety Code Div.20,Chap.6.7 and Title 23 California Code of Regulations Chap. 16. <br /> - - - - -- - - - -- - - - - - - - - - - - - - - - -- <br /> - - - - - - - - - <br /> 17717 1 an an ecor erne apace y Contents Permit status System type <br /> 236U B 390002313320133208 PIT0006603 2,000 UNLEADED DOUBLE WALLED <br /> 2360 7 390002313320133207 PT0006601 5,000 DIESEL Active DOUBLE WALLED <br /> 2360 5 390002313320133205 PT0006593 2,000 OTHER Active DOUBLE WALLED <br /> 2360 4 390002313320133204 PT0006589 10,000 UNLEADED Active DOUBLE WALLED <br /> Underground Storage Tank Permit Conditions <br /> 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 <br /> these Permit Conditions. <br /> 2) In order to maintain the operatingpermit,the permit holder shall comply with the H&S Code,Div.20,Chap. 6.7 and 6.75;and CCR,Title 23,Chap. 16 and <br /> 18,as well as any conditions established by San Joaquin County. <br /> 3) If the Tank Operators)is different from the Tank Owner,or if the Permit to Operate is issued to a person other than the owner or op <br /> erntor of the tan/:,the <br /> Permittee shall ensure that both the Tank Owner and tank Operator receive a copy of the permit. <br /> 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Environmental Health Division(PHS/EHD)and are considererd <br /> UST Permit Conditions. Copies of the Procedures and Emergency Response Plan must be attached to this permit or be available for review and/or inspection VUST site shall comply with the monitoring procedures referrenced in this permit. <br /> 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently if specified by the <br /> equipment manufacturer,and provide documentation of such servicing to this office. <br /> 7) In the event of spill,leak,or other unauthorized release,the Perrnitee shall comply with the requirements of Title 23 CCR,Chap. 16,Art.5,and the <br /> approved Emergency Response Plan. <br /> 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 <br /> from the date the monitoring was performed. <br /> 9) The PHS/EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change. <br /> 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 subjectto <br /> review,modification or revocation. <br /> l 1) Construction,repair and/or removal permits are required from the PHS/EHD prior to any change,repair or removal of UST system equipment. <br /> 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 <br /> of this permit. <br /> 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. <br /> 14) A"Conditional"Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. <br /> r <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: LODI CITY OF <br /> Tank Owner: LODI CITY OF/DENNIS CALLAHAN <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: LODI MUNI SERVICE CENTER Facility ID FA0003961 <br /> 1331 S HAM Ln Account ID AR0003575 <br /> LODI, CA 95240 Issued 9/2812000 <br /> Billing Address: ATTN : LODI MUNI SERVICE CENTER <br /> LODI MUNI SERVICE CENTER <br /> 221 W PINE ST <br /> LODI, CA 95240 <br /> 7023,rpt <br />