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SAN JOAQ , COUNTY PUBLIC HEALTH'SESCES 304 E.WEBER AVE.,THIRD FLOOR • STOCKTON,CA 95202 PHONE(209)468-3420 �, s KAREN FURST, M.D., M.P.H., HEALTH OFFICER ;r DONNA RERAN, R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION ENVIRONMENTAL HEALTH I SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE rogram Permit Permit Record ID Number Program Code and Description Valid PR023107 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/00 To 12/31/00 Underground Storage Tank Program: California Health and Safety Code Div.20,Chap.6.7 and Title 23 California Code of Regulations Chap. 16. an anK Kecoror ap cry Contents Permitus System I ype LeaK De ec ion Active 2362 4 390002310740507938 PT0009411 10,000 REGULAR UNLEADED Active DOUBLE WALLED AUTOMATIC TANK GUAGE 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 operatingpermit,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 Penn it Conditions. Copies ofthe Procedures and Emergency Response Ian must be attached to this permit or be available for review and/or inspection 5) �th UST site. Ire�Penntttee 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 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 and be 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 subjectto 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. i 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. L 14) A"Conditional"Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. a PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: 7-ELEVEN INC Tank Owner: SOUTHLAND CORPORATION THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES 'c Regulated Facility: 7 ELEVEN STORE#20632 B/2237 Facility ID FA0002541 4627 DA VINCI DR Account ID AR0003348 STOCKTON, CA 95207 Issued 1/26/2001 Billing Address: ATTN : GASOLINE ACCOUNTING 7- ELEVEN INC PO BOX 711 DALLAS, TX 75221 7023.rpt