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BILLING_PRE 2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2200 - Hazardous Waste Program
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PR0514378
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BILLING_PRE 2019
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Entry Properties
Last modified
5/22/2019 2:05:38 PM
Creation date
11/1/2018 10:57:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
BILLING_PRE 2019
FileName_PostFix
PRE 2019
RECORD_ID
PR0514378
PE
2220
FACILITY_ID
FA0003776
FACILITY_NAME
KWIK SERV*
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
01
SITE_LOCATION
420 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\K\KETTLEMAN\420\PR0514378\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
3/9/2018 10:48:23 PM
QuestysRecordID
3824864
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E.Weber Ave.,Third Floor•Stoduon,CA 95202-2708• Phone(209)468-3420 <br /> Donna Heran,RE.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> Permit <br /> Program ermit Valid <br /> Record ED Number Pro(pam and Description <br /> PRO514378 PT0010581 2220-SMALL UANTITY HAZARDOUS WASTE GENERATOR FACILITY <br /> 1/1/2005 To 12131/2005 . <br /> azardous Waste Generator Program: <br /> In ord o maintain the permit to operate, ardous Waste Generators shall comply with California Health and Safety Code,Div.20,Chap.6.5,Art.2-13, <br /> Ia Coda of Regulations,Chap_20:.-------------------------------------------------------------------------------------------- <br /> Sec,25100 a-s-----------------`--- - - <br /> 1M12005 To 1213112005 <br /> PR0231906 2300-UNDERGROUND STORAGE TANK FACILITY <br /> Underground Storage Tank Program: <br /> California Health and Safe Code,Div.20,Cha_6.7 and Title 23,_Califomia Code of Regulationsr Chap:16-------------------------------------------------------------- <br /> -ty- . - - - — p ty <br /> --_- ----_.-- Leak Detection <br /> P Tan Tank Recor ID Permit q apaci Contents Permit Status System Type <br /> OTHER Conditional DOUBLE WALLED i5onunuow Irserstitlal Monitoring <br /> 2362 5 390002319060190605 PT0004748 550 DOUBLE WALLED Continuous Imarstitial Monitoring <br /> 2360 11 390002319060508230 PT0009611 7,000 MIDGRADE UNLEADED Conditional DOUBLE WALLED Continuous Interstitial Monitoring <br /> 2360 12 390002319060508231 PT0009614 6,000 PREMIUM UNLEADED Conditional <br /> REGULAR UNLEADED Conditional DOUBLE WALLED Oommu so,Imerstitim Monitoring <br /> 2360 13 390002319060508232 PT00096110,000 DOUBLE WALLED Continuous Interstitial Monitoring <br /> 2360 14 390002319060508233 PT0009612 8,000 MIDGRADE UNLEADED Conditional <br /> Underground Storage Tank Permit Conditions <br /> 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 Were Permit Conditions. <br /> 2) In order to maintain the operating permit,the owner and operator sari comply with the H&S Code,Div.20,Chap.6.7 and 6.75;and CCR,Title 23,Chap.16 and Ig,u well at any conditions <br /> established by San Joaquin County. <br /> 3) If the Tank Operators)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 mutt be approved by the Environmental Health Department(17ID)and arc 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 Permitee shall comply with the requirements of Title 23 CCR,Chap.16,Ail 5,and the approved Emergency Response Plan. <br /> 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 <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. <br /> 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 <br /> revocation. <br /> 11) Construction,repair and/or removal permits are required from the END prior to my change,repair or removal of LIST system equipment. <br /> 12) 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 /> 13) This Permit to Operate shall not be considered permission to violate my laws,ordinances or statutes of any other Federal,State or Local agency. <br /> 14) A"Conditional"Permit may be revoked if corrections specified on the inspection report are not completed by the dates) indicated <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: SHELL OIL PRODUCTS US <br /> Tank Owner. SHELL OIL PRODUCTS <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facility ID FA0003776 <br /> Regulated Facility. TOKAY SHELL` <br /> Account <br /> 420 W KETTLEMAN LN ID p <br /> LODI CA 95240 slued 41228/2008/2005 <br /> 56 <br /> Billing Address: <br /> TOKAY SHELL* <br /> 420 W KETTLEMAN LN <br /> LODI CA 95240 <br /> 7023.rpt <br />
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