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SAN JOAQUIN COUNTY ENVIRONN ENTAL HEALTH IJEPARTMENT
<br /> 304 E.Weber Ave.,Thud Floor•Stodrron,CA 95202-2708•Phone(209)468-3420
<br /> Donna Hcr=6 R.EH.S.,Director
<br /> ENVIRONMENTAL HEALTH
<br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br /> PERMIT TO OPERATE
<br /> tomReNumber Program a and Description PeValid
<br /> PRO518530 PT0012082 2220-_WALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/2007 To 12/31120(17
<br /> �dazardous Waste Generator m:
<br /> Ino In a 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 at seq,and Title 22,California Code of Regulations,Chap.20,____________.____.________
<br /> PR0231911 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/2007 To 1213112007
<br /> Underground Storage Tank Program:
<br /> Califomia Health and Safety Code:Div,20,Chap,6 7.and Title 23,California Code of Regulations,Chap,16..............................................................
<br /> PIE Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection
<br /> 2362 4 390002319110505682 PT0008228 10,000 REGULAR UNLEADED Active,billable DOUBLE WALLED Ccmanuoos Interstitial Monitoring
<br /> 2360 5 390002319110505683 PT0008226 5,000 REGULAR UNLEADED Active,billable DOUBLE WALLED Comnums Interstitial Monitoring
<br /> 2360 6 390002319110505684 PT0008227 5,000 DIESEL Active,billable DOUBLE WALLED Continuous Interstitial Monitoring
<br /> = f 2.4927MZ1_'
<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 systems)fails to remain in compliance with these Pcrmit Conditions.
<br /> 2) In order to maintain the operating permit,the owner and operator shell comply with the H&S Code,Div.20,Chap.6.7 and 6.75;and CCA,Tide 23,Chap. 16 and 18,as well ss 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 tank,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 Environmental Health Department(EHD)and are considered UST Pemdt Conditions. The approved
<br /> monitoring,response,and plot plans shall be maintained onsite with the permit.
<br /> 5) The Permittee shall comply with the monitoring procedures referenced 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 equipment manufacturer,and
<br /> provide documentation of such servicing to this office.
<br /> 7) In the event of a spill,leak,or other unauthorized relcme,the Pennitee shall comply with the requirements of Title 23 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 inspection for a period of at least three years from the date the monitoring was
<br /> performed.
<br /> 9) The 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 subject to review,modification or
<br /> revocation.
<br /> 11) 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 annual 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 datc(s) indicated.
<br /> PERMITS TO OPERATE are NOT TRANSFERABLE
<br /> Bond may be SUSPENDED or REVOKED for cause.
<br /> PERMIT(s)Valid only for: BURGIN, GARY
<br /> DBA: COUNTRYSIDE MINI MART
<br /> PHIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> Regulated Facility COUNTRYSIDE MINI MART Facility ID FA0000540
<br /> 14971 N HWY 88 Account ID AR0000539
<br /> LODI CA 95240 Issued 2/13/2007
<br /> Billing Address:
<br /> COUNTRYSIDE MINI MART
<br /> 14971 N HWY 88
<br /> LODI CA 95240
<br /> 7023.rpt
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