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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E. Weber Ave., Third Floor • Stockton, CA 95202-2708 0 Phone (209) 468-34220 Donna Heran, R.&H.S., Director ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE Permit Program Permit program Code and Description Valid Record ID Number 1/1/2002 To 12/3112002 PR023112 2300 - UNDERGROUND STORAGE TANK FACILITY Underground Storage Tank Program: California Health and Safety Code Div_ 20, Chap_- --- and Title 23 Ca_li_fo_rn_i- Code o_f__R__egulations Chap_ 16. __________________ vP,,,,it Ctatmc System Type Leak Detection 2360 8 390002311270508152 PT0009561 4,000 DIESEL Active, Dluaoie "" "'-- Monitoring 2360 7 390002311270508151 PT0009560 8,000 PREMIUM UNLEADED Active, billable DOUBLE WALLED Continuous Interstitial Monitoring 2362 6 390002311270508150 PT0009559 12,000 REGULAR UNLEADED Active, billable DOUBLE WALLED Continuous Interstitial Monitoring 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 owner and operator 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 Department (EHD) and are considererd UST Permit Conditions. The approved monitoring, response, and plot plans shall be maintained onsite with the pertnit. 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. S) 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 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 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 date(s) indicated. PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s) Valid only for: PAKZAD, FRED Tank Owner: FRED PAKZAD THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Facility ID FA0003611 Regulated Facility: PARKWOODS BEACON* Account ID AR0003189 1612 W HAMMER LN Issued 3/29/2002 STOCKTON. CA 95209 Billing Address: ATTN : F PAKZAD, M HAMZEH, A HAJIAN PARKWOODS BEACON' 1612 W HAMMER LN STOCKTON, CA 95209 7023.rpt