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SAN JOAQUIN COUNTY ENVIRON'VIENTAL HEALTH DEPARTMENT 1868 E. Hazelton Ave. • Stockton,CA 95205-6232 • Phone (209) 468-3420 Donna Heran,R.E.H.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 PRO521930 - PT0014827-- 2220—SMAtt-QUANTITY-HAZARDOUS-WASTE-GENERATOR-FACILATY-- - ----1/-1f20%-To 12/31/201-a Hazardous Waste Generator Program: In order to maintain the permit too erate,Hazardous Waste Generators shall comply with California Health and Safety Code,Div.20,Chap.6.5,Art.2-13, Sec.25100 et seg and Title Cali_ rI Code of Regulations,Chap.20_ PRO517565 2300- NDERGROUND STORAGE TANK FACILITY 1/1/2013 To 12/31/2013 Underground Storacie Tan Pro ra California Health and Safet e,Div.20,Chap.6.7 and Title 23,California Code of Regulations,Chap.--1-6._ _ ____ --------------------------------------------------- P/E Tank Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection 2362 1 390005175650515606 PT0011677 20,000 REGULAR UNLEADED Active,billable DOUBLE-WALL Continuous Interstitial Monitoring 2360 2 390005175650515607 PT0011678 10,000 DIESEL Active,billable DOUBLE-WALL Continuous Interstitial Monitoring 2360 3 390005175650515608 PT0011679 10,000 PREMIUM UNLEADED Active,billable DOUBLE-WALL Continuous Interstitial Monitoring BOE ID#: 44040801 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 permit,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 Operators)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 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 Permit Conditions. The approved monitoring,response,and plot plans shall be maintained onsite with the permit. 5) The Permittee shall comply with the monitoring procedures referenced in this permit. 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 Title 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 monitoring was performed. 9) 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. 1 1) Construction,repair and/or removal permits are required from the EHD prior to any change,repair or removal of UST system equipment. 12) This Permit to Operate shall not be considered permission to violate any laws,ordinances or statutes of any other Federal,State or Local agency. 13) A"Conditional"Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- PERMITS TO OPERATE may be SUSPENDED or REVOKED for cause. PERMIT(s) Valid only for: SAFEWAY INC THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES SAFEWAY #2600 FacilitylD FA0013603 Regulated Facility: 1987 W ELEVENTH ST Account ID AR0022603 TRACY CA 95376 Issued 2/19/2013 Billing Address: ATTN : MS #6516 TAX, NASC SAFEWAY #2600 PO BOX 29096 MS 6516 PHOENIX AZ 85038-9096 7023.rpt