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SAN JOjdkUIN COUNTY PUBLIC HEALTHRVICES <br /> P O Box 388 MW STmKToN, CA 95201-0388 • Pno 209) 468-3420 <br /> ERNEST M. FUJIMOTO, M.D., M.P.H., ACTING HEALTH OFFICER <br /> DONNA RERAN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> L-*TRATING PERMIT FOR UNDERGROUND STORAGE TAW FACILITY <br /> Tank Tank Permit Annual Permit Fee Valid <br /> PIE lumber Record IG 4iaber Capacity Contents Remit Status From To <br /> 2331 C _ <br /> 1 TA1 31 i c tEM Unleaded -0—Active Kermit —`01 01/95 Ta17 '" <br /> PERMIT CONDITIONS! <br /> 1) The PERMIT TO OPERATE will become void if ANNUAL PERMIT Fees and SERVICE Fees are net paid and/or the UST system(s) fails <br /> to remain in compliance with the PERMIT C-1-MITIOlS. <br /> 'I) The PERMIT TO OPERATE is granted to the TAW (VCR who accepts responsibility for operating and monitoring the U'ST system <br /> according to State u-,&rground storage tank laws and regulations as well as any conditions established by San Joaquin County. <br /> S) The TAW; OPERATOR(S), if different from the tank owner, shall operate and monitor tte UST system according to the WRITTEN <br /> OPERATING AGREEMENT required under Section 152*93, Chapter E+.7, Division 20, California Health and Safety Code. <br /> A) The TANK OWNER shall notify ttre Environmental Health Division of any proposed change in operation or ownership of the MIST <br /> system. <br /> 5) Upon any change in equipment, design or operation of this facility, the PERMIT TO OPERATE will be reviewed by the <br /> Environmental Health Division. <br /> 5) A construction or removal permit is required from the Environmental Health Division prior t* any removal or <br /> change of UST system equipment. <br /> 7) This PERMIT TO OPERATE shall not be considered permission to violate any existir, laws, ordinance_ or statutes of other <br /> federal, state or local agencies. <br /> + <br /> PERMIT TO OPERATE an UST FACILITY issued to; PACIFIC BELL ENVIRONMENTAL ONME NTAL M(3T <br /> PO BOX 1 Si;38/2E,.c 6 WATT AVE #d <br /> SACRAMENTO, CA 9S851 <br /> PERMITS TO OPERATE and ANNUAL. PERMIT FEE PAYMENTS are NOT 'TRANSFERABLE <br /> and may LSE SUSPENDED or REVOKED for cause . <br /> THIS FORM MUST BE DISPLAYED CONSPICtXIUSLY ON THE PREMISES <br /> REGULATES FACILITY; PACIFIC BELL Account il)c 0003SS5 <br /> 1812 COLEY _ Facility ICS; 0039,�.r�, <br /> � �a5•_,gtr P t Printed: -t/I i/9 <br /> E:��4.•At_ hi . CA ermi �.� <br /> BILLING ADDRESS <br /> PACIFIC: BELL <br /> ATTN ; PERMIT DESK <br /> PO BOX 15038/2646 WATT AVE #4 <br /> SACRAMENTO, CA 9 8S I <br />