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SAN J AQUIN COUNTY ENVIRONMENT TAL HEALTH DEPARTMENT
<br /> 304 E. eber Ave.,Third Floor• Stockton,CA 95202-2708• Phone(209)468-3420
<br /> Donna Heran, RF-H.S.,Director
<br /> ENVIRONMENTAL HEALTH
<br /> S N JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br /> PERMIT TO OPERATE
<br /> Program Permit Permit
<br /> Record ID Number Program Code and Description Valid
<br /> PRO518332 PT0011967 2220-SM NLL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/112004 To 12/31/2004
<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, Crap.6.5,Art.2-13,
<br /> Sec.25100 et seq,and Title 22,Californ a Code of Regulabons,Chap.20_
<br /> PR0231069 2300-UN ERGROUND STORAGE TANK FACILITY 1/1/2004 To 12/31/2004
<br /> Underground Storage Tank Program:
<br /> California Health and Safety Code,Div_0 ,Chap.6.7 and IIte 23,California Code of Regulations,Chap, 16_
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<br /> P;E Tank# Tank Record ID Permit# Ca_aaty Contents Permit Status System Type Leak Detection
<br /> 2360 5 390002310690508127 PT0009544 3.000 REGULAR UNLE=DED Active, billable DOUBLE WALLED C:rrjnuous Interstitial Monitoring
<br /> 2362 4 390002310690508126 PT0009543 9.000 REGULAR UNLEADED Active,billable DOUBLE WALLED Crunuous Interstitial Monitoring
<br /> Underground Storage Tank Permit Conditions
<br /> 1) The Permit to Operate will become void if nual Permit Fees and S_nice Fees are not paid andcr the UST system(s)fails to remain in compliance wit::t'aesz P_-rmit Conditions.
<br /> 2) In order to maintain the operating permit,the Dwrier and operator sh2:1:.--ply with the H&S Code.D', 1_0.Chap.6.7 and 6.75;and CCR,Title 23,Chap.16 aa3 15.a;well as any conditions
<br /> established by San Joaquin County.
<br /> 3) If the Tank Operator(s)is different from the Tank Owner,or if the Perot to Operate is issued to--Terson other than the owner or operator of the tank,th-z PT shall ensure that both
<br /> the Tank Owner and tank Operator receive x copy of the permit.
<br /> 4) Written Monitoring Procedures and an Emer ncy Response Plan r ns:`<approved by the Envirotm e-.ul Health Department(EHD)and are considererd UST Ferri;Codons. The approved
<br /> monitoring,response,and plot plans shall be maintained onsite with:�<_emtit.
<br /> 5) The Permittee shall comply with the monitoring procedures referenced M:his permit.
<br /> 6) The Permittee shall perform testing and preventive maintenance on a:'.leak detection monitoring equipment annually,or more frequently if specified by the ec=Tera 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 Perr::a shall comply with the reg4ments of Title 23 CCR,Chap.16,Art.5,and the app<rovs_'Emergency Response Plan.
<br /> 8) Written records of all monitoring performed shall be maintained on-,-:L by the operator and be available for inspection for a period of at least three year f=x daze the monitoring was
<br /> performed.
<br /> 9) The EHD shall be notified of any change in oAlnership or operation of&x UST system within 30 days cf such change.
<br /> 10) Upon any change in equipment,design oroperation of the UST sys::-r(including change in tank contents or usage),the Permit to Operate will be subject rn r°.iew,modification or
<br /> 1 1) N-&%d44lbn,repair and/or removal permits are required from the EHD:Tor to any change,repair or removal of UST system equipment
<br /> 12) The Pemuttee shall submit an annual report dDCumenting compliance> the UST Permit Conditions r id-in 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 staru%mss of any other Federal,State or Local agency.
<br /> 14) A"Conditional"Permit may be revoked i Fcorrections specified on t..e 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: SINGH, BAKHSIS
<br /> Tonk Owner: BAKHSIS, SINGH; SUKHBIR, KAUR
<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> Regulated Facility. COUNTRY CLUB FOOD 8r FUEL MINI MART Facility'D FA,0001909
<br /> 1856 W COUNTRY CLUB BLVD Account lD AR0001916
<br /> STOCKTON, C A 95204 Issued 4/1/2004
<br /> Billing Address: ATTN : BAKHSIS SINGE
<br /> COUNTRY CLUB FOOD & FL=L MINI MART
<br /> 1856 W COUNTRY CLUB BLV:
<br /> STOCKTON, CA 95204
<br /> 7023.rpt
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