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} • SAN JOAOIN COUNTY PUBLIC HEALTH S.VICES ( 304 E. WEBER AVE.,TiIIRD FLOOR STOCKTON,CA 95202 PRONE(209)468-3420 (= } KAREN FURST, M.D., M.P.H., HEALTH OFFICER ' DONNA.HF-.RAN, R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION s ENVIRONMENTAL HEALTH F SAN JOAQUIN COUNTY CERTIFIED UNI FI ED PROGRAM AGENCY PERMIT TO OPERATE rograIn Permit Permit Record ID Number Program Code and Description Valid PRO50835 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/00 To 12/31/00 N Underground Storage Tank Program: California Health and Safety Code Div.20,Chap.6.7 and Title 23 California Code of Regulations Chap. 16. lank P I ank Recordcrrnr apace v t on cn s IlernlitSlatLIS ys em I ype Leak Detection 2 390005083520508354 PT0009664 15,000 PREMIUM UNLEADED Active 2360 1 390005083520508353 PT0009663 20,000 REGULAR UNLEADED Active DOUBLE WALLED INTERSTITAL MONITOR Underground Storage Tank Permit Conditions 1) The Permit to Operate wil I 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. 2) in order to maintain the operatingpermit,the penuit 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 conditions established by San Joaquin County. 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 both the Tank Owner and tank Operator receive a copy of the permit. 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Divironmental Health Division(PHS/EHD)and are considererd 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 5) thsUST site. lie ermrl(ee shall comply with the monitoring procedures referrenced in this permit. 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently ifspecitied by the equipment manufacturer,and provide documentation of such servicing to this office. T 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 s approved Emergency Response Plan. 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(late the monitoring was performed. 9) The PHS/EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change. '4` 10) tlpon any change in equipment,design or operation of the UST system(including change in tank contents or usage),the Pennit to Operate will be subject to review,modification or revocation. 1 1) Construction,repair and/or removal permits are required from the PHS/El ID prior to any change,repair or removal of UST system equipment. 12) The Permittee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the anniversary date ofthe issuance of this permit. 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. 14) A"Conditional"Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: CHEVRON USA PRODUCTS CO : DBA: CHEVRON STATION #91848 '1'1115 FORM MUSTRE DISPLAYED CONSPICUOUSLY ON TIiF,PREMISES X-: Regulated Facility: CHEVRON STATION#208118 Facility ID FA0008044 3355 E HAMMER LN#-004 Account ID AR0015141 Y,< STOCKTON, CA 95212 Issued 10/13/2000 ��. Billing Address: ATTN : CHEVRON STATIONS INC CHEVRON STATION#208118 - PO BOX 6004 SAN RAMON, CA 94583 7023.rpt • ..