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r` SAN JOA*i COUNTY PUBLIC HEALTH S&VICES <br /> ,:. P O Box 388 0 STOCKTON, CA 95201-0388 • PHONE 09) 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 /> U)PERATING Pte!I T FOR I RGROKM STORAGE TANK FACILITY <br /> Tank Tank Permit Annual Permit Fee Valid <br /> P/E Number Record 10 lumber Capacity Contents Permit Status From To <br /> 23 N 001 TA176601 006319 10,000 Unleaded 01 Active Permit. 011O1/95 12/311195 <br /> 2380 002 TA176602 004:'20 10,000 Unleaded 01 Active Permit tai?011/95 12/31/95 <br /> 2350 003 TA176603 00432i 10,E Unleaded 01 Active p=ermit 01101/95 12/31/95 <br /> 2300 004 TA176604 00432'- 1,000 Unleaded 01 Active Permit 01,/01/15 121131/9+5 <br /> PERMIT CONDITIONS: <br /> 1) The PERMIT TO OPERATE will become ;roil if ANNUAL PER141T Fees and SERVICE Fees are not paid and/or the LIST system(s) fair <br /> to remain in compliance with the PERMIT CONDITIONS. <br /> 2) The PERMIT TO }OPERATE is granted to the TAW OWER who accepts responsibility for operating and monitoring U-* EST system <br /> according to State underground storage tank laws and regulations as well as any conditions established by San Joaquin County. <br /> 3) The TAW, OPERATOR(S), if different from the tar ( owner, shall operate and monitor the UST system according to the WRITTEN <br /> OPERATING AGREEMENT required under Section 25293, Cftapter 6.7, Division 20, California Health and Safety Cr&-. <br /> 4) The TAN' 00 shall notify the Environmental Health Division of any proposed change in ovation or ownership of the IIST <br /> system. <br /> 5) Upon any change in equipsent, design or operation of this facility, the PERMIT TO OPERATE 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 /> change of UST system equipment. <br /> 7) This PERMIT TO OPERATE shall not be 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; CHEVRON USA INC: <br /> PO E;OX .5004 <br /> SAN RAMON, CA 9S683 <br /> PERMITS TO OPERATE and ANNUAL. PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for o ausse. <br /> THIS FORM !MUST BE DISPLAYED CONSPICM)SLY ON THE PREMISES <br /> REGULATED FACILITY` WATERLOO C:HEVRa,-.}N Account TD.- 000:3296 <br /> 3F 6 <br /> 4400 WATERLOO RD Facility ID, 00:3717 <br /> STOCKTON, CA 9S205 Permit Printed: 08/21/95 <br /> BILLING ADDRESS: <br /> CHEVRON_USA <br /> ATTN: KATHY N�_RRIS/FE'RMIT DESK <br />