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SAN JOA' N COUNTY PUBLIC HEALTH AWICES <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 HERAN, R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> Program Permit Permit <br /> Record ID Number Program Code and Description <br /> Valid <br /> PR023199 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/01 To 12/31/01 <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 /> P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status <br /> 2360 11 390002319950199511 PT0005511 2,500 WASTE OIL Active <br /> 2360 10 390002319950199510 PT0005510 10,000 UNLEADED Active <br /> 2360 9 390002319950199509 PT0005173 10,000 UNLEADED Active <br /> 2362 8 390002319950199508 PT0005172 10,000 UNLEADED Active <br /> 900,4 D#:n 44=o 4958 f' <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 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 18,as well as any <br /> conditions established by San Joaquin County. <br /> 3) If the Tank 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 <br /> 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 considererd UST Permit Conditions. <br /> Copies of the Procedures and Emergency Response Plan must be attached to this permit or be available for review and/or inspection at the UST site. <br /> 5) The Permittee 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 equipment manufacturer, <br /> and provide documentation of such servicing to this office. <br /> 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 <br /> 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 from the date the monitoring <br /> 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 subject to review,modification or <br /> revocation. <br /> 1 1) Construction,repair and/or removal permits are required from the PHS/EIID 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 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 /> 1 <br /> ' l <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: TOSCO NORTHWEST CO <br /> DBA: CIRCLE K STORES <br /> Tank Owner: CIRCLE K STORES INC <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: CIRCLE K STORES INC#5446* Facility ID FA0006438 <br /> 1403 W COUNTRY CLUB BLVD Account ID AR0008425 <br /> STOCKTON. CA 95204 Issued 5/21/2001 <br /> Billing Address: ATTN : LICENSING DEPT DC36 <br /> TOSCO NORTHWEST CO <br /> PO BOX 52085 <br /> PHOENIX, AZ 85072-2085 <br /> 7023.rpt 0 0 <br />