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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 JOAN COUNTY PUBLIC HEALTH SLICES <br /> 304 E. WEBER AVE.,THIRD FLOOR • STOCKTON,CA 95202 • PHONE (209) 468-3420 <br /> KAREN FURST,M.D., M.P.H., HEALTH OFFICER <br /> DONNA HERRN,R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> _ <br /> Tit <br /> Re ogrm <br /> d[D Number Program Code and Description Valid <br /> PRO51437 PT0010581 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 111100 To 12131100 <br /> Hazardous Waste Generator Program: <br /> California Health and Safely Code Div. 20,Chap.6.5,Art.2-13 Sec.25100 et seq,and Title 22 California Code of Regulations,Chap.20. <br /> ---- --- - - -- - - - -bERGRO - - - - ----- TANK_ _ __-- 111100 To 12/31100 <br /> PR023190 .2300-UNDERGROUND STORAGE TANK FACILITY ' <br /> Underground Storage Tank Program: <br /> California Health and Safety Code Div.20,Chap.6.7 and Title 23 California Code of Regulations Chap. 16. -- -_ -- --_ - <br /> an, eor ermi __ __apa Iy__ _ __ _on en_ ____ ___erml aus_ ___-y m iypc a cion <br /> rib IaoK9 <br /> ve <br /> 2360 13 390002319060508232 PT0009613 10,000 REGULAR UNLEADED Active DOUBLE WALLED INTERSTITAL MONITOR <br /> 2360 14 390002319060508233 PT0009612 8,000 MIDGRADE UNLEADED Active DOUBLE WALLED INTERSTITAL MONITOR <br /> 2360 11 390002319060508230 PT0009611 7,000 MIDGRADE UNLEADED Active DOUBLE WALLED INTERSTITAL MONITOR <br /> 2360 5 390002319060190605 PT0004748 550 NON MVF Active <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 <br /> these Permit Conditions. <br /> 2) In order to maintain the operating permit,the permit holdershall comply with the H&S Code,Div.20,Chap.6.7 and 6.75;and CCR Title 23,Chap. 16 and <br /> 18,as well as any conditions established by San Joaquin County, <br /> 3) Ifthe Tank 0 erator(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 tan/:,the <br /> Permittee shall ensure that both the Tank Owner and tank Operaor receive a cpporrpy of the permit. <br /> be <br /> 4) WritUSTt Permit CondiitProcedures and an tions. Copies of the Procedures and Response <br /> EmergePlan <br /> cy Response Plane must bethe <br /> atached tothislpermitior be available orlreview and/or are inererd <br /> spection 10UST site. <br /> 5) �ermntee shall comply with the monitoring procedures referrenced in this permit. <br /> 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently iFspecified by the <br /> equipment manufacturer,and provide documentation ofsuch servicing to this office. <br /> 7) In the event of a spill,leak,orother unauthorized release,the Pernitee shall comply with the requirements of Title23 CCR Chap. 16,Art.5,and the <br /> approved Emergency Response Plan. <br /> 8) Written records of all monitoring performed shall be maintained on-site by the opemtor and be available for inspection fora period of at least three years <br /> from the date the monitoring was performed. <br /> 9) The PHS/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 <br /> review,modification or revocation. <br /> 11) Construction,repair and/or removal permits are required from the PHS/EHD prior to any change,repair or removal of UST system equipment. <br /> 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 <br /> of this permit. <br /> 13) This Permit to Operate shall not be considered permission to violate any laws,ordinances or statutes of any other Federal,Stale or Local agency. <br /> 14) A"Conditional"Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indioated. <br /> PE�may <br /> O OPERATE are NOT TRANSFERABLE <br /> PERM <br /> SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: EQUILON LLC ENTERPRISES <br /> Tank Owner: SHELL OIL COMPANY <br /> THIS FORST MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facility ID FA0003776 <br /> Regulated Facility: TOKAY SHELL` Account ID AR0003356 <br /> LO DI, CA 955240240 I,KET LN Issued 9128/2000 <br /> 7023.rpt <br />
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