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SAN JOIN COUNTY PUBLIC HEALTHfVVICES <br /> 304 E.WEBER AVE., IRD FLOOR • STOCKTON,CA 95202 E (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 /> OPERATING I T FOR UMERGROUND STORAGE TANS: EAC I L I TY <br /> Tank Tank Permit Annual Permit Fee Valid <br /> P/E Number Record ID Number Capacity Contents Permit Status Frca To <br /> ?330 003 TA100203 005224 5,000 unleaded 02 Conditional Permit 01=-/01/99 12/31/99 <br /> PERMIT CONDITIONS: <br /> 1) The PERMIT TO OPERATE will become void if 4 .X PERtIT Fees and SERVICE Fees-are not paid and/or the UST system(s) fails <br /> to remain in compliance with the PERMIT CONDITIONS. <br /> 2) The PERMIT'TO OPERATE is granted to the TANK OWNER who accepts responsibility for operating and monibDring the UST system <br /> according to State underground storage tank laws and regulations as well as any conditions established by San Joaquin Canty. <br /> 3) The TANK, OPERATOR(S), if different from the tank owner, shall operate and monitor the UST system according to the WRITTEN <br /> OPERATING AGREEMENT required-under Section 25293, Chapter 6.7, Division 20, California Health and Safety Code. <br /> 4) The TAW OWNER shall notify the Environmental Health Division of any proposed change in operation or ownership of the UST <br /> system. <br /> 5) Upon any change in equipment, design or operation of this facility, the PERMIT TO OPERATE will be reviewed by the <br /> Environmental Health Division. <br /> 5) 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 t* violate any existing laws, ordinances or statutes of other <br /> federal, state or local agencies. <br /> •S) A "Conditional Permit" may be revoked if corrections are not completed by the date(s) specified on inspection. <br />[ # # # :# <br /> PERMIT TO OPERATE an UST FACILITY issued to. DAMERON HOSPITAL <br /> TAS_ <br /> 52S W ACACIA <br /> STOCKTON, CA 952 <br /> PERMIT'S TO OPERATE and ANNUAL PERMIT EEE PAYMENTS are NOT TRANSFERABLE <br /> and mica be SUSPENDED or REVOKED for c aiuse . <br /> THIS FORM MUST BE DISPLAYED Ct>NSPICUOUSLY ON THE PREMISES <br /> RERLATED FACILITY; DAMERON HOSPITAL Account ID: 0t 633 <br /> S2S ISI ACACIA Facility ID, 002864 <br /> TO0-".TI Ohl, GA 9520:3 Permit Printed; 05/03/99 <br /> BILLING ADDRESS, DAMERON HOSPITAL <br /> ATTN: ACCTS PAYABLE-MARGIE <br /> 525 W ACACIA <br /> =TOC KTON, CA 9S203 <br />