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' - SAN JOAQ ' N COUNTY PUBLIC HEALTH SE#ICES <br /> ,I� <br /> 304 E.WEBER AVE., , D FLOOR • STOCKTON,CA 95202 • Pi (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 /> SATING SIT FOR UMERGROUND STORAGE TAW FACILITY <br /> Tank Tank Permit Annual Permit Fee Valid <br /> P/E Number Record ID Number Capacity Contents Permit- Status From To <br /> 2360 07 TA505059 08533 12,00 unleaded 41 Active Permit 01/01/99 12/31/F9- <br /> 2360 005 T450E�)S7 008,534 12,04 unleaded 01 Active Permit 01/01/99 12/31199 <br /> 23460 CX)6 TA51060-SS 445515 12,00 Unleaded 41 Active Permit 01/01/99 12/31/99 <br /> PERMIT CONDITIONS: <br /> 1) The PERMIT TO OPERATE will become void if ANNIAL PERMIT Fees and SERVICE Fees are not paid and/or the UST system(s) fails <br /> to remain in compliance with the PERMIT CONDITIONS. <br /> 2) The PERMIT TO OPERATE is granted to the TANK 0WNER who accepts responsibility for operating and monitoring Vie UST system <br /> according to State underground storage tank laws and regulations as well as any conditions established by San Joaquin County. <br /> 3) The TANK OPERATOR(S), if different from the tank owner, shall operate and monitor the UST system according to the WRITTEN <br /> OPERATING AGREEMENT required under Section 25243, Chapter 6.7, Division 20, California Health and Safety Code. <br /> 4) The TANK MER shall notify the Environmental Health Division of any proposed change in operation or ownership of the UST <br /> system. <br /> 5) Upon any change in equipment, design or operation of this facility, the PERMIT TO OPERATE will be reviewed by the <br /> Environmental health Division. <br /> 6) A construction or removal permit is required from the Environmental Health Division prior to any removal or <br /> change of UST system equipment. <br /> 7) This PERMIT TO OPERATE shall not be consideree permission to violate any existing laws, ordinances or statues of other <br /> federal, state or local agencies. i <br /> PERMIT TO OPERATE an UST FACILITY issued to, KEN PAIGE <br /> 236 N HAM LANE <br /> LOD! , CA 95240 <br /> PERMIT'S, TO OPERATE and ANNUAL PERMIT FEE PAYMENTS' ;-;.-r e NOT TRANSFERABLE <br /> and riiay be SUSPENDED c,r REVOKED foy-- c;-ju-e . <br /> TINTS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> REGULATED FACILITY; LAKEWO O CHEVRON USDA #41:53# Account ID: 003290 <br /> '."36 N HAM LN Facility ID: 03711 <br /> LODI , CA 95240 Permit Printed: 04/2$/99 <br /> BILLING ADORES:: PAIGE, KEN <br /> ATTN : KEN PAIGE <br /> _;IS- N HAM LN <br /> LOD P. CA 9S240 <br />