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BILLING PRE 2019
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2300 - Underground Storage Tank Program
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PR0231760
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BILLING PRE 2019
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Entry Properties
Last modified
11/20/2023 11:45:15 AM
Creation date
8/23/2019 11:27:00 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0231760
PE
2351
FACILITY_ID
FA0003831
FACILITY_NAME
WATERLOO FOODMART
STREET_NUMBER
4315
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215-2305
APN
08710034
CURRENT_STATUS
01
SITE_LOCATION
4315 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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KBlackwell
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EHD - Public
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N SAN JOA;t,.jIN COUNTY PUBLIC HEALTH SOICES <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 HERAN, R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br />ENVIRONMENTAL HEALTH <br />SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br />PERMIT TO OPERATE <br />Permit <br />Program Permit Program Code and Description Valid <br />Record ID Number <br />PR0231760 2300 - UNDERGROUND STORAGE TANK FACILITY 1/1/01 To 12/31/01 <br />Underground Storage Tank Program: <br />California Health and Safe Code Div_ 20, Cha 6.7 and Title 23 California Code of Regulations Chap._16- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - . <br />- - - - - - - - - - - - - - - - - CY P- _ no... 4 ct—, Ck,crP n Tune Leak Detection <br />2360 7 390002317600505388 PT0007955 15,000 PREMIUM UNLEADED ACUve DOUBLE WALLED INTERSTITAL MONITOR <br />2362 6 390002317600505387 PT0007954 15,000 REGULAR UNLEADED Active <br />BOE]_Df. 44-0000'74 7 ' <br />Underground Storage Tank Permit Conditions <br />I ) 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 <br />Conditions. <br />2) In order to maintain the operating permit, 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 18, as well as <br />any conditions established by San Joaquin County. <br />3) If the Tank Operator(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 <br />ensure that both the Tank Owner and tank Operator receive a copyof 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 UST Permit <br />Conditions. Copies of the Procedures and Emergency Response Plan must be attached to this permit or be available for review and/or inspection at the USC site. <br />5) The Permittee 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 equipment <br />manufacturer, and 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 T@le 23 CCR, Chap. 16, Art. 5, and the approved Emergency <br />Response Plan. <br />8) Written records of all monitoring performed shall be maintained on-site by the operatorand be available for inspection fora period of at least three }ears from the date the <br />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 ofthe UST system (including change in tank contents or usage), the Permit to Operate will be subject to review, <br />modification or revocation. <br />11) 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 ofthe issuance ofthis 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 are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />PERMIT(s) Valid only for: EQUILON LLC ENTERPRISES <br />Tank Owner: SHELL OIL CO <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />Facility ID FA0003831 <br />Regulated Facility: WATERLOO SHELL Account ID FA 0003 31 <br />4315 WATERLOO RD Issued 312912001 <br />STOCKTON. CA 95205 <br />Billing Address: ATTN : WATERLOO SHELL <br />WATERLOO SHELL <br />4315 WATERLOO RD <br />STOCKTON, CA 95205 <br />7023. rpt <br />
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