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SAN JOOUIN COUNTY PUBLIC HEALTHOVICES 304 E.WEBER AVE.,THiRD FLOOR • STOCKTON,CA 95202 • PHONE(209)468-3420 KAREN FURST, M.D., M.P.H., HEALTH OFFICER DONNA HERRN, R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNI FI ED PROGRAM AGENCY PERMIT TO OPERATE Pro ogrrdam Permit Permit Reco11) Number Program Code and Description Valid PR023143 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. 511K 9 1 an•Recoird I ii PermitCapacity C on ens vernut5latus ,ys em I ype I,eak uctection 231JU 4 390002314300507863 PT0009356 12,000 PREMIUM UNLEADED Active 2360 5 390002314300507864 PT0009355 12,000 REGULAR UNLEADED Active DOUBLE WALLED AUTOMATIC TANK GUAGE BOE1DC"`44-018763 Underground Storage Tank Permit Conditions 1) The Permit to Operate will become void if Annual Permit Fees and Service Gees 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,Ti tie 23,Chap. 16 and 18,as well as any conditions established by San.loaquin County. 3) i fthe 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 Monitorin%Procedures and an Emergency Response Plan must be approved by the Environmental Health Division(PHS/E111))and arc considererd UST Pemiit Conditions. Copies of the Procedures and Emergency Response Plan must be attached to this permit or be available for review and/or inspection 5) �tlicfernpttec shall comply with the monitoring procedures referrenced in this permit. 6) The Permittee shall perlorm testing and preventive maintenanceon all leak detection monitoring equipment annually,or more frequently ifspecilied by the equipment mamltacturer,and provide documentation of such servicing to this office. 7) in the event of a spill,leak,or other unauthorized release,the Pemritee shall comply with the requirements of Title 23 CCK,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 ofat least three years from the date the monitoring was performed. 9) The PHS/EiiD 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 ofthe 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 PIIS/EHDprior to any change,repair or removal of UST system equipment. 12) The Permittee shall submit an annual report documenting compliance with the UST Pcrmit 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 arc 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: QUIK STOP MARKETS INC DBA: QUIK STOP THIS FORM MUST BE DISPLAYED CONSPICEIOUSLV ON THE PREMISES Regulated Facility: QUIK STOP#121 Facility ID FA0000848 1196 W LOUISE AVE Account ID AR0002241 MANTECA, CA 95336 Issued 1016/2000 Billing Address: ATTN : QUIK STOP QUIK STOP#121 4567 ENTERPRISE ST FREMONT, CA 94538 7023,rpt 0 0