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SAN JOAQJWC COUNTY PUBLIC HEALTH SE CES <br /> P O Box 388 • N, CA 95201-0388 • PHONE 468-3420 <br /> ERNEST M. FUJIMOTO, M.D., M.P.H., ACTING HEALTH FFICER <br /> DONNA RERAN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> TING PERMIT FOR UNDERGROUND STORAGE TAW FACILITY <br /> Tank Tank Permit Annual Permit Fee Valid <br /> P/E Number Record I0 Number Capacity Contents Permit Status From To <br /> 2.380 007 TA505814 MC . 42 4,040 Diesel 01 Active Permit 01/01/% 12/31/% <br /> 2,W-0 006 TA50,%13 008343 8,000 Unleaded 01 Active Permit. 01101/'_- 12/31/' <br /> 2MO 005 TA505812 0h8344 12,000 Unleaded 01 Active Permit 01/01/96 '12/31!96 <br /> PERMIT CONDITIONS: <br /> 1) The PERMIT TO OPERATE will become void if ANNUAL PERMIT Fees and SERVICE Fees are not paid and/or the LIST system(s) fails <br /> to remain in compliance with the PERMIT CONDITIONS. <br /> 2) The PERMIT TO OPERATE is granted to the TANK CHER 0o accepts responsibility for operating and monitoring the UST system <br /> according to State underground storage tank lasts and regulations as well as any conditions established by San Joaquin County. <br /> 3) The TAN{ OPERATOR(S), if different from the tank owner, shall operate and monitor the IJST system according to the MITTEN <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, sign 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 /> 4'• <br /> PERMIT TO OPERATE an l,'ST FACILITY issued to; NEW WEST PETROLEUM <br /> 1831 16TH ST <br /> SACRAMENTO, CA 95814 <br /> PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for c ause•. <br /> THIS FORM QST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> REGULATED FACILITY; COUNTRY CLUB EXXON* Account ID; 0003410 <br /> 2705 COUNTRY CLUB BLVD Facility ID; 00204; <br /> STOC:KTON, CA 95204 Permit Printed; 05/16/96. <br /> BILLING ADDRESS, <br /> COUNTRY CLUP EXXON* <br /> ATTN; NEW WEST PETROLEVM <br /> 1831 16TH ST <br /> SACRAMENTO,, CA 95814 <br />