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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 600 E. Main St. • Stockton,CA 95202-3029 • Phone (209)468-3420
<br /> Donna Heron,R.E.H.S., Director
<br /> ENVIRONMENTAL HEALTH
<br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br /> PERMIT TO OPERATE
<br /> Program. Permit Permit
<br /> Record ID Number Program Code and Description Valid
<br /> PR0513740 PT0009935 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/2011 To 12/31/2011
<br /> Hazardous Waste Generator Program:
<br /> In order to maintain the permit to operate, Hazardous Waste Generators shall comply with California Health and Safety Code, Div. 20,Chap.6.5,Art.2-13,
<br /> Sac,25100 et seg,-and Title 22,California-C-o--d-e of Regulations,Chap.20.
<br /> --- ---------------------- ---------------------------------
<br /> 4 R
<br /> .. ------- ----PR 312111 -UNDERGROUND STORAGE TANK FACILITY 1NI2011 To 12131/2011
<br /> d Gt ra a Ta k Pr, m;
<br /> California Health and Safety Code,Div.20,Chap.6,7 and Title 23,California Code of Regulations,Chap,16_ _ _____
<br /> - OO----- -._ .......
<br /> P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection
<br /> 2372 10 390002312110515704 PT0014868 20,000 REGULAR UNLEADED Active,billable DOUBLE WAILED Continuous Interstitial Monitoring
<br /> 2370 11 390002312110515705 PT0014869 10,000 DIESEL Active,billable DOUBLE WALLED Continuous Interstitial Monitoring
<br /> 2370 12 390002312110515706 PT0014870 10,000 PREMIUM UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial Monitoring
<br /> PCM I pA.AQ0408014A,.=I-
<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 these Permit Conditions.
<br /> 2) In order to maintain Bre operating permit,die owner and operator shall comply with Bre H&S Code,Div.20,Chep.6.7 and 6.75;and CCR,Title 23,Chap.16 and 18,as well as any conditions
<br /> established by San Joaquin County.
<br /> 3) If the Tank Opemtor(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 rank,the Permittee shall ensure that both
<br /> 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 Enviromnental Health Department(EHD)and are considererd LIST Pettit Conditions. The approved
<br /> monitoring,response,and plot plans shall be maintained onsite with the permit.
<br /> 5) The Permittee shop comply with the monlmring procedures referenced in this permit.
<br /> 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoringequipment annually,or more frequently if specified by the equipment manufacturer,and
<br /> provide documentation of such servicing to this office
<br /> 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,An.5,and the approved Emergency Response Plan.
<br /> 8) Written records of all monitoring perfon'aed 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
<br /> performed.
<br /> 9) The EHD shall be ratified of any change in ownership or operation of the UST system witl»n 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 subject to review,modification or
<br /> revocation.
<br /> l l) Construction,repair and/or removal permits are required from the EHD prior to any change,repair or removal of UST system equipment.
<br /> 12) The Permittee shall submit an mould report documenting compliance with the UST Permit Conditions within 30 days of the date of the issuance 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 /> PERMITS TO OPERATE may be SUSPENDED or REVOKED for cause.
<br /> PERMIT(s)Valid only for: SAFEWAY INC
<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> SAFEWAY FUEL CENTER#2707 Facility ID FA0002409
<br /> Regulated Facility:
<br /> 6425 PACIFIC AVE AccountlD AR0004604
<br /> STOCKTON CA 95207 Issued 2/4/2011
<br /> Billing Address: ATTN : MS #6516 TAX NASC
<br /> SAFEWAY FUEL CENTER #2707
<br /> PO BOX 29096
<br /> PHOENIX AZ 85038-9096
<br /> 7o2e.rpt
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