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r SAN IN COUNTY PUBLIC HEALIAVICES 304 E.WEBER AVE.,THIRD FLOOR - STOCKTON,CA 95202 - PHONE(209)468-3420 KAREN FURST, M.D., M.P.H., HEALTH OFFICER DONNA HERAN,R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE Program Permit Permit Record ID Number Program Code and Description Valid PR051624 2300-UNDERGROUND STORAGE TANK FACILITY 1129/01 To 12/31/01 Underground Storage Tank Proaram: California Health and Safety Code Div_20,Chap_6.7 and Title 23 California Code of Regulations Chap. 16. __________ ------- -------- P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type 2360 2 390005162480515526 PT0011198 15,000 UNLEADED Active,.billable DOUBLE WALLED 2362 1 390005162480515525 PT0011197 20,000 UNLEADED Active,billable DOUBLE WALLED Underground Storage Tank Permit Conditions 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. 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 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 Environmental 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 at the UST site. 5) The Permittee shall comply with the monitoring procedures referenced in this permit. 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, and provide documentation of such servicing to this office. 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 Plan. 8) Written records of all monitoring performed shall be maintained on-site by the operator andbe available for inspection for a period of at least three years from the date 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. 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 revocation. 11) Construction,repair and/or removal permits are required from the PHS/EHD 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 of the 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 dates) 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 THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Regulated Facility: CHEVRON STATION#209167 Facility ID FA0012532 1234 E YOSEMITE AVE Account ID AR0020562 MANTECA. CA 95336 Issued 8/27/2001 Billing Address: ATTN : CHEVRON PRODUCTS% PERMIT DESK CHEVRON STATION#209167 PO BOX 6004 SAN RAMON, CA 94583 7023.rp1