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SAN JOAO& COUNTY PUBLIC HEALTHCES <br /> P O Box 388 • x, 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 /> OPMTING PERIMIT FOR UNDERGRMM STMAGE TAW FACILITY <br /> Tanis Tank Permit. Annual Permit Fee Valid <br /> E Number Retard 19 !!tuber Capacity Contents Permit Status From To <br /> 2 0 TA505419 0079 ; 10,000 Diesel 01 Active Permit 01101/97 12!31997 <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 IiST system(s) fails <br /> to remain in cc liance with the PERMIT CONDITIONS. <br /> 2) The PERMIT TO OPERATE is granted to the TK OWNER who accepts responsibility for operating and monitoring the UST system <br /> according to State underground storage tank laws and regulations as well as any conditions estabiished by San Joaquin County. <br /> 3) The TANK OPERATOR(S), if different from the tank ter, shall operate and monitor the UST system according to the WRITTEN <br /> OPERATING AGREEMENT requirsq+ under Section 25293, Chapter 6.7, Division 20, California Health and Safety Code. <br /> I) Rhe TANK OWNER shall notify the Environmental Health Division of any proposed change in operation or ownership of the UST <br /> system. <br /> 5) UKn any charge in equipment, design or operation of this facility, the PERMIT TO OVERATE 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 /> cha, of UST system equipment. <br /> 7) This PERMIT TO OPERATE shall reit be considered permission to violate any existing laws, ordinances or statutes of other <br /> federal, state or local agencies. <br /> + ?# <br /> PERMIT TO OPERATE an UST FACILITY issued to: <br /> ? <br /> f <br /> PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br /> and may oe SUSPENDED or REVOKED for cause . <br /> THIS FORM DUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> REGULATED FACILITY: Si GENERAL HOSPITAL* Account ID; 0WYA <br /> r IT, Facility ID: 0t? <br /> FRENCH CAMP, CA '-23Permit Printed; 02126197 <br /> BILLING ADDRENi SJ GENERAL HOSPITAL* <br /> ATTN: SJ CO HEALTH CARE SERVICES <br /> PO BOX 1020 <br /> '-TOCKTON, CA 95201 <br />