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SAN JOAQMN COUNTY PUBLIC HEALTH SERVICES <br /> P O Box 388 AWTMKMN, CA 95201-0388 • PHONE ) 468-3420 <br /> ERNEST M. FUJIMOTO, M.D., M.P.H., ACTING HEALTH OFFICER <br /> DONNA RERAN, R.E.H.S.,DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> OPERATING PERMIT FOR k-44DERGROUND STORAGE TANK FACILITY <br /> Tari; Tank rermit krual p;niit. Fee Val. : <br /> r!ENumber Record 10 _ #wester Capacity Contents remit Status r��a To _ <br /> 2M _ 001 TA149701 V1 5 it);DCtD Unleaded sal Active Permit 01140 r.5 .121lW1la5 <br /> i#J2 TR14S7ft? C0SX7 10,000 Of.her ul Active Permit 1lGll35 112"31/11-41; <br /> 2380 003 TA149703 0,C5.,m,S toow Diesel vi Active Permit 01/0!!SS 1201/95 <br /> PERMIT C OND I T I ONS t <br /> 1) The PERMIT TO OPERATE will become void if A.NRl1A! PERMIT Fees and SERVICE Fees are not paid andior the {)C;TsystaqFt,; aii5 <br /> to remain in compliance with the PERMIT CONDITIONS. <br /> 2) The PERMIT TD OPERATE is granted to the TANK OWNER who accepts responsibility for operating and monitoring the {QST system <br /> according to 'State umde-rground storage tank laws and regulations as well as any conditions established by "ani Joaquin County. <br /> 3) The TAW OPERATOR(S), if different from the tank owner, shall operate and monitor the (JiST system according to the WRITTEN <br /> ERATING AGREEMENT required under Section 25293, Chapter 6.7, Division 20, California Health and Safety Code. <br /> 4) The TAW.. CSR shall 1%)tify the Environmental Health Division of any proposed change in operation or ownership of the IST <br /> system. <br /> S) upon any change in equipment, design or operation of this facility, the PERMIT TO OPERATE will be reviewed by tfe <br /> Environmental Health Division. <br /> b) A construction or removal permit is required from the Environmental health Division prior to any reiKival or <br /> change of UST system equipment. <br /> 7) This PERMIT Tv OPERATE shall not to 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,, jAC K L, RUTH HOSE <br /> 1040 COAL I E,SRN 11 A ST <br /> E&CALON, CA 9-15:3-20 <br /> PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause, <br /> THIS FOR! QST BE DISPLAYED C=C S'ICt ,L'Y ON THE PREMISES <br /> RE .ATED FACILITY, ESCALON MINI MART Account ID; 0008E-,93 <br /> 3 <br /> 1097 YOSEMITE Facility ID; 000279 <br /> ESCALi N, CA 95320 Permit Printed; 08.11 1 X99 <br /> BILLING ADDRESS: <br /> ESC:ALON MINI DART <br /> 'ATTN; ESCALt:N MINI MART <br /> 1097 YOSEMITE <br /> ESCALi N, CA 95320 <br />