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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E.Weber Ave.,Third Floor• Stockton,CA 95202-2708 • Phone(209) 468-3420 <br /> Donna Herm,RE.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGR _NI AGENCY <br /> PERMIT TO OPERATE <br /> Program Penn:; Permit <br /> Record ID Number Program Code and Description Valid <br /> PR0518530 PT0012082 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 11112004 To 121312004 <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 /> Sec.25100 etseq._and Toe 22,California Code of Regulations,Chap,20, -- <br /> PR0231911 2300-UNDERGROUND STORAGE TANK FACILITY 1/112004 To 121312004 <br /> Underground Storage Tank Program: <br /> California Healthand Safety Code,Div.20,Chap.6.7 and Title 23,-California Code of Regulations,Crap_ 16._ -----------------------_____-.___________________._.. <br /> P/E Tank# Ta:'k Record ED Permit# Capacity Contents Permit Status System Type Leak Detection <br /> 2362 4 390002319110505682 PT0008228 10,000 REGULAR UNLEADED Active, billable DOUBLE WALLED Continuous Interstitial stua_Y.ng <br /> 2360 6 390002319110505664 PT0008227 5,000 DIESEL Active.billable DOUBLEWALLED Continuous imemamal Sli <br /> 2360 5 390062319110505683 PT0008226 5,000 REGULAR UNLEADED Active. billable DOUBLE WALLED Continuous Intersuual Abn_:nng <br /> BOEID#: '44-024927 <br /> Underground Storage Tank Permit Conditions <br /> II The Permit to C1vrate sill become s'oid if Annual Permit Fees and Service Fees are not paid and/or the UST sysemu l fails to remain in compliance with these Permit Conditions. <br /> 2) In order to mai:r+in the:pen!ing permit.the owner and operator shall comply with the H&S Code.Div.20,Chap.6.7 anc 5.75:and CCR.Title 23.Chap.16 and 18,as well as any contdom <br /> established hp Sr.Icac_n County. <br /> 3) If the Tank Opt:man s� s different from the Tank Owner,or if the Permit to Operate is issued to a person other than Se owner or operator of the tank,the Permittee shall ensure tea[Mrh <br /> the Tank Owne:and Opemtor receive a copy of the permit. <br /> 4) Written Monitor-no Pr..edures and an Emergency Response Plan most be approved by the Environmental Health Deparnareent(EHD)and are considererd UST Permit Conditions. The approved <br /> monitoring,respmee.acd plot plans shall be maintained onsite with the permit. <br /> 5) The Permittee shall corsly with the monitoring procedures referenced in this pemdt. <br /> 6) The Pennittec sail pe=omt testing and preventive maintenance on all leak detection monitoring equipment annually_orrtrore frequently if specified by the equipment manufacturer.and <br /> provide documentatioc ofsuch servicing to this office. <br /> 7) In the event of a spill.:eak.or other unauthorized release.the Perri shall comply with the requirements of Tide_CCR Chap.16,Art.5,and the approved Emergency Response Plan. <br /> 8) Written records of all monitoring performed shall be maintained on-site by the operator and be available for inyectim for a period of at least three years from the date the monitoring as <br /> performed. <br /> 9) The EHD shall be tpa-:d of any change in o,nership or operation of the UST system within 30 days of such change. <br /> 10) Upon any change in ec apmemr.design or operation of the UST system(including change in tank contents or usage).cbe Pcrtnit to Operate will be subject to review,modification or <br /> 11) L4Yfi1905116n,repair ant or removal pemdts are required from the EHD prior to any change,repair or removal of LST sys equipment <br /> 12) The Pemutlee s'mll sutcdt an annual report documenting compliance with ire UST Permit Conditions within 30 days of%be date of the issuance of this pemut <br /> 13) This Permit to Opeae shall not be considered permission to violate any laws,ordinances or statutes of any other Fedmal.State or local agency. <br /> 14) A"Conditional-Penni: may be revoked if conections specified on the inspection report are not completed by the date(s) indicated. <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: BURGIN, GARY <br /> DBA: COUNTRYSIDE MINI MART <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY O\THE PREMISES <br /> Regulated Faciliy. COUNTRYSIDE MINI MART Facility ID FA0000540 <br /> 14971 N HWY 88 Account ID AR0000539 <br /> LODI, CA 95240 Issued 4/1/2004 <br /> Billing Address <br /> COUNTRYSIDE MINI MART <br /> 14971 N HWY 88 <br /> LODI, CA 95240 <br /> 7a23.rpl <br />