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<br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT s
<br /> 600 E. Main St. • Stockton, CA 95202-3029 • Phone(209)468-3420.
<br /> Donna Heran,R.E.H. irector
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<br /> ENVIRONMENTAL HEALTH `
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<br /> ` SAN`JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br /> PERMIT TO OPERATE "
<br /> Program Permit - Permit
<br /> Record ID Number Program Code and Description Valid
<br /> PRO513679 PT0009874 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/2009 To 12/31/2009
<br /> ,,,Hazardous Waste Generator Program:
<br /> Jn order to maintain the permit to operate,Hazardous Waste Generators shall comply with California Health and Safety Code,Div,2Q Chap;6.5,Art.2-13,
<br /> Sec.25100 et seq and Title 22,California Code of Reulations,Chap.20____
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<br /> ' RR0234736—r- '- <;"'` 300-UNDERGROUND STORAGE TANK FACILITY.: 1/1/2009 . ^IW3112009
<br /> inderground Storage Tank Program:
<br /> California Health and Safety Code DIv.20 Chap. and Tifle 23 > arnla Code of Regulations Chap 16_
<br /> P dank# Tank Record I Permit# Capacity Contents Permit Status System Type Leak Detection
<br /> 360173604x,`PT0004758 10,000 DIESEL. Active,billable DOUBLE WALLED Continuous Interstitial Monitoring
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<br /> 8ergro6nd storage TankPermit Conditions ,
<br /> 1) The Permit to Operate will become void if Annual Permit Fees and Seryice Fees are not paid and/or the UST system(s)fails to remain in compliance with t(rese`Perritit Conditions
<br /> 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
<br /> established by San Joaquin County.
<br /> 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
<br /> the Tank Owner and tank Operator receive a copy of the permit.
<br /> 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
<br /> monitoring,response,and plot plans shall be maintained onsite with the permit.
<br /> 5) The Permittee shall comply with the monitoring procedures referenced in this permit.
<br /> 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
<br /> provide documentation of such servicing to this office.
<br /> 7) In the event of a spill,leak,or other unauthorized release,the Permttee shall comply with the requirements of Title 23 CCR,Chap.16,Art.5,and the approved Emergency Response Plan
<br /> 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 Momtoring,was
<br /> performed.
<br /> 9) The EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change. a
<br /> 10) Upon any change in equipment,design or operation of the UST system(including change to tank contents or usage),the;PGttitit to,Operate wilt tie ubject,to raviewt Modification or
<br /> revocation.
<br /> Construction,repair and/or removal permits are required from the EHD prior to any change,repair of removal of UST system equipment.
<br /> I The.,Permittee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the date of the issuance of this permit:'
<br /> Th_sPetmit to p&-te shall not be considered permission to vra -._.1 tt'y laws,ordinances or statutes of any other Federal,State or Local agency. t
<br /> ; ) bit maybe revoked if correct peCt CA Conditional'; 6$q the inspection report are not completed by the date(s) indicated
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<br /> PERMITS TO OPERATE are NOT TRANSFERABLE
<br /> and may be SUSPENDED or REVOKED for cause. '
<br /> PERMIT(s)Valid only for: SUTTER TRACY COMMUNITY HOSP
<br /> 4 DBA: SUTTER TRACY COMMUNITY HOSPITA
<br /> Tank Owner: TRACY COMMUNITY MEMORIAL HOSP I
<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> Regulated Facility: SUTTER TRACY COMMUNITY HOSP ` ¢ + s t, Facility ID FA0002562 } t* t
<br /> Y 1420 N TRACY BLVD ; „ A R a ;� r, ` ' Account ID AR0002387
<br /> fi TRACY CA 95376 �r�G Issued
<br /> �. 2/4/2009 3, u
<br /> Billing Address.
<br /> SUTTER TRACY COMMUNITY HOSP
<br /> T . r 1420 N TRACY BLVD `r
<br /> 5A r
<br /> TRACY CA 95376 3497 a
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