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COMPLIANCE INFO_1986-2000
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231692
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COMPLIANCE INFO_1986-2000
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Last modified
12/28/2023 11:21:04 AM
Creation date
6/3/2020 9:51:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1986-2000
RECORD_ID
PR0231692
PE
2361
FACILITY_ID
FA0000212
FACILITY_NAME
Mossdale Chevron
STREET_NUMBER
444
Direction
W
STREET_NAME
MOSSDALE
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
444 W MOSSDALE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2361_PR0231692_444 W MOSSDALE_1986-2000.tif
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EHD - Public
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SAN JOIN COUNTY PUBLIC HEALTH #VICES �. <br /> 304 E.WEBER AVE.,THIRD FLOOR • STOCKTON,CA 95202 • PHONE(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 /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> Permit <br /> Program Permit Program Code and Description Valid <br /> Record ID Number b 1/1/00 To 12/31/00 <br /> PR023169 2300-UNDERGROUND STORAGE TANK FACILITY <br /> Underground Storage Tank Program: <br /> California Health and Safety Code Div.20,Chap.6.7 and Title 23 California Code of Regulations Chap. 16. <br /> - <br /> - - --- <br /> ----- --------- - - - ea <br /> an an ecor erml Capacity on ens erml a us ys em y <br /> Active <br /> DOUBLE WALLED IN I ERSTITAL <br /> DOUBLE WALLED INTERSTITAL MONITOR <br /> 2360 5 390002316920508177 PT0009577 6,000 REGULAR UNLEADED Active DOUBLE WALLED INTERSTITAL MONITOR <br /> 2360 4 390002316920508176 PT0009576 10,000 PREMIUM UNLEADED Active <br /> Underground Storage Tank Permit Conditions <br /> 1) The Permit to Operate will become void if Annual Permit Fees and Service Fees are not paid and/or the UST system(s)fails to remain in compliance with <br /> these Permit Conditions. <br /> 2) In order to maintain the operating permit,the permit holder shall comply with the H&S Code,Div.20,Chap.6.7 and 6.75;and CCR Title 23,Chap. 16 and <br /> 18,as well as any conditions established by San Joaquin County. an the owner or operator of the tank,the <br /> Operate <br /> is issued to <br /> a person other than <br /> the Permit to O Pe <br /> 3) If the Tank Operator(s)is different from the Tank Owner, <br /> or if P <br /> Permittee shall ensure that both the Tank Owner and tank Operator receive a copy of the permit. <br /> 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Environmental Health Division(PHS/EHD)and are con <br /> sidererd <br /> UST Permit Conditions. Copies of the Procedures and Emergency Response Plan must be attached to this permit or be available for review and/or inspection <br /> th UST <br /> 5) itsite. <br /> lte ePermuttee shall comply with the monitoring procedures referrenced in this permit. <br /> 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently if specified by the <br /> equipment manufacturer,and provide documentation of such servicing to this office. <br /> 7) In the event of a spill,leak,or other unauthorized release,the Pernitee shall comply with the requirements of Title 23 CCR,Chap. 16,Art.5,and the <br /> approved Emergency Response Plan. <br /> 8) Written records of all monitoring performed shall be maintained on-site by the operator and be available for inspection for a period of at least three years <br /> from the date the monitoring was performed. <br /> 9) The PHS/EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change. <br /> 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 subjectto <br /> review,modification or revocation. <br /> 11) Construction,repair and/or removal permits are required from the PHS/EHD prior to any change,repair or removal of UST system equipment. <br /> 12) The Permittee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the anniversary date of the issuance <br /> of this permit. <br /> 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. <br /> 14) A"Conditional"Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. <br /> PERMITS TO OPERATE are NOT TRANSFERABLE p <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: BOKIDES, MEL <br /> DBA: MEL BOKIDES PETROLEUM <br /> Tank Owner: MEL BOKIDES <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facility ID FA0000212 <br /> Regulated Facility: MBP MOSSDALE" Account ID AR0000211 <br /> 444 W MOSSDALE RD Issued 9/2812000 <br /> LATHROP, CA 95330 <br /> Billing Address: ATTN : NICK BOKIDES <br /> MBP MOSSDALE" <br /> PO BOX 914 <br /> LODI, CA 95241 <br /> 7023.rpt � • <br />
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