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h + SANT JOAC`3UIN COUNTY ENVIRONMF.NT :L HEALTH DEPARTPAENT �T 304 E.Weber Ave.,Third Floor*Swdaon,CA 95202-2708 Phone(209)468-3420 g E ' Donna Heran,R.LH.S.,Director SAN 30tt7FIEIE & ENCY PERMIT TO OPERATE Program Permit Permit Record ID Number Program Code and Description Valid PR05_1C� 62 PT0011201 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 111!2005 70 12/3112005 ' Ll z.ardous Waste Generator Pro ram: in order to maintain the permit to operate,Hazardous Waste Generators shall comply with California Health and Safety Code, Div.20,Chap.6.5,Art.2-13, Sec � �t segranditt� ria Code of Regulations,Chap.20: - ------------- C, - — — Pr023"1614 23 -UNDERGROUND STORAGE TANK FACILITY 111/2005 To 12/31/2005 ;Gal ornia Health and Safety Code,Div-20 Chap.6.7 and Title 23,California Code of Regulations:Chap. 16. E ------- --- -- --- ------- - ---- --- --- - - --- -- ' D E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Ihafi Detection 1:36'2- 6 390002316140505419 PT0007988 10,000 DIESEL Active,billable DOUBLE_mNALLEU Continuous interstitial Mon;±orirg IUnderground Storage Tank Permit Conditions 1) the Permit to Operate will become void ifAnnual Permit Fees and Service Fees are not paid and/or the UST system(s)fails to remain in compliance with these Permit Conditions. ng permit,the owner and operator 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 any conditions 2j In order to maintain the operati established by San Joaquin County. 3) If the"rank 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 ensure that both ¢,r< the Tank Owner and tank Operator receive a copy of the permit. 4) Written Monitoring Procedures:and an Emergency Response Pian must be approved by the Environmental Health Department(EHD)and are considererd UST Permit Conditions. The approved monitoring,response,and plot plans shall be maintained onsite with the permit. S) The Permittee,hall comply with the monitoring procedures referenced in this permit, 6). The Permittee shall perform testing and preventive maintenance on all leak detcetion monitoring equipment annually,or more frequently if specified by the equipment manufacturer,and provide documentation of such servicing to this office. 7) In the event of a spill,leak,or other unauthorized release,the Permitee shall comply with the requirements of Title 23 CCR,Chap.16,Art.5,and the approved Emergency Response Plan. 8) Written records of all monitoring performed shall be maintained on-site by the operator and be available for inspection fora period of at least three years from the date the monitoring was performed. 9) The EHD shall be notified of any change in ownership or operation of the UST system within 30 days efsuch change. 10) Upon any change in equipment,design or operation of the UST system(including change in tank contents or usage),the Permit to Operate will be subject to ren iew,modification or revocation. 11) Construction,repair and/or removal permits are required from the EHD prior to any change,repair or removal of UST system equipment. I 2) 'rhe Permittee shall submit an annual report doedu:xnting compliance with the UST Permit Conditions within 30 days of the date or"the issuance ofthis penmii. 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. 1 4) A"Conditional"Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: SAN JOAQUiN CO HEALTH CARE Tank Owner: S J GENERAL HOSPITAL w^ THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Regulated Facility: SJ GENERAL HOSPITAL.* Facility ID FA0000086 500 W HOSPi"FAL RD Account ID AROOCOO85 FRENCH CAMP, CA 95231 Issued 2/10/2005 Billing Address: ATTN ACCOUNTS PAYABLE SJ GENERAL HOSPITAL* PO BOX 2.499 FRENCH CAMP, CA 95231 o23.rpt e