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SAN JON COUNTY PUBLIC HEALTH VICES <br /> \ 304 E.WEBER AVE., RD FLOOR • STOCKTON,CA 952 A (209)468-3420 <br /> KAREN FURST M.D., M.P.H., HEALTH OFFICER <br /> DONNA HERRN,R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> 4 <br /> ENVIRONMENTAL HEALTH <br /> .RATING PERMIT FOR UNDERGROKM UNDERSTORAGE TAW FACILITY <br /> Tare. Tank. Permit Annual Permit Fee Valid <br /> piE hyamer Record 1D Number Capacity Contents Permit Status From To <br /> TA545419 79 3 10,0.? Diesel €.+1 Motive Permit 01/01/98 111/31198 <br /> PERMIT CONDITIONS: <br /> D The PERMIT TO OPERATE will become void if ANCAL PERMIT Fees ars, SERVICE Fees are not paid and/or the OST system(s) fails <br /> to remain in compliance with the PERMIT CONDITIONS. <br /> 2% The PERM11T TO OPERATE is granted to the TAW OWNER who accepts responsibility for operating and monitoring the I.JST system <br /> according to State underground storage ta*-: la=ws and regulations as well as any conditions established by San Joaquin County. <br /> 3) The TANX, OPERATOR(S), if different from the tang owner, shall operate and monitor the !JST system according to the WRITTEN <br /> OPERATING AGREEMENT required under Section 25233, Chapter 6.7, Division 20, California Health and Safety Code. <br /> 4) The TAt . OWNER shall notify the Environmental Health Division of any proposed change in operation or ownership of the L)ST <br /> system. <br /> S) 11pon any change in equipment, design or operation of this facility, the PERMIT TO OPERATE will be reviewed by the <br /> Environmental Health Division. <br /> 5) A construction or removal permit is required from the Environmental Health Division prior to any removal or <br /> change of LIST system equipment. <br /> 7) This PERMIT TO 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 FACILITv, issued to; <br /> PERMIT: TO OPERATE and ANNUAL PERMIT FETE PAYMENT'.* ar- NC�`�` TF;-NSFERABLE <br /> and may be '=;tiSPE:NDE:D }r REVOKED f o r cause . <br /> THIS FORM MUST BE DISPLAYED C ONSPIC:UOUSLY ON THE PREMISES <br /> REG{ILATED FACILITY: '...T GENERAL HO':*PITAL* Account ID; &V1085 <br /> 500 t1 HOSPITAL RD Facility IDS 000086 <br /> FRENCH CAMP, CA 9S231 Permit Printed; 03102/98 <br /> BILLING ADDRESS, '=;.i GENERAL HOSPITAL* <br /> AT T N; Si CO HEALTH CARE SERVICES <br /> PCI BCI X 1020 <br /> STOC:KTCIN, CA 9G*2 01 <br />