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_tea <br /> ` SAN JOA?#N N COUNTY PUBLIC HEALTH S ICES <br /> 304 E.WEBER AVE., RD FLOOR • STOCKTON,CA 95202 PH (209)468-3420 <br /> KAREN FURST,M.D., M.P.H.,HEALTH OFFICER <br /> DONNA RERAN,R.E.H.S.,DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> n—FlMATING PERMIT FOR UNDER61"M STORAGE TAW FACILITY <br /> Tank Tank Permit Annual Permit Fee Valid <br /> PIE Number Recon ID Number Capacity Contents Permit Status From To <br /> 315 007 TAS06059 008-93 12jCW Unleaded 01 Active Permit 01/0lf°2, 12/31/98 <br /> 2=315 005 TAS060S7 0085:34. 12,000 Unleaded 01 Active Permit. 01/01/98 12/31/98 <br /> 23iS 006 ?AS06058 009535 12,000 Unleaded 01 Active Permit. 01/01/98 12/31/9-8 <br /> PERMIT CONDITIONS: <br /> 1) The PERMIT TO OPERATE will become void if ANNUAL PERMIT Fees and SERVICE Fees are not paid and/or the LIST system(s) fails <br /> to remain in ccepliance with the PERMIT' 'CONDITIONS. <br /> 2) The PERMIT TO OPERATE is granted to ttie TANK OAR who accepts responsibility for operating .and monitoring the LIST system <br /> according to State underground storage tank laws and regulations as well as any conditions established by San Joaquin County. <br /> 3) The TAW OPERATOR(S). if different from the tank ower. shall operate and monitor the UST system according to the WRITTEN <br /> OPERATING AGREEMENT required under Section 25293, Chapter 6.3, Division 20, California Health and Safety Code. <br /> 4) The TANK OWNER shall notify the Environmental Health Division of any proposed change in operation or ownership of the UST <br /> system. <br /> S) 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 arty removal or <br /> chane of UST system equipment. <br /> 7) This PERMIT TO OPERATE shall not be considered permission to violate any existing laws, ordinances or statutes of other <br /> federal, state or local agencies. <br /> PERMIT TO OPERATE an UST FACILITY issued to, KEN PAIGE <br /> 23G. N HAM LANE <br /> LORI , CA 99240 <br /> PERMIT'-_-" TO OPERATE and ANNUAL PERMIT FEE PAYMENT'S; ars NOT TF.;=N'=.F'ERABLE <br /> and may be SUSPENDED or REVOKED f o r cause . <br /> THIS FORM WJST BE D1} C0CPIC=0LY ON THE PREMISES <br /> REGI.)LLATED FACILITY; LAKEWOOD CHEVRON USA #4183* Account. IDU 0003290 <br /> 236 N HAM Lha Facility ID: 003711 <br /> LODI , CA 95240 Permit Printed: 03/02/9,8 <br /> BILLING ADDRESS; PAIGE, �--:EN <br /> ATTN : YEN PAIGE <br /> -C� a HAM LN <br /> LOD I , CA 'a2'40 <br />