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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E.Weber Ave.,Third Floor•Stockton,CA 95202-2708• Phone(209)468-3420 Donna Heran, REH.S., Director ENVIRONMENTALHE HEALTH JNsNcv PERMIT TO OPERATE Program Permit Permit Record ID Number Program Code and Description Valid PRO514210 PT0010413 2227-HAZARDOUS WASTE GENERATOR FACILITY 111/2003 To 1 2/3112003 Hazardous Waste Generator Program' California Health and Safely Code,Div.20 Chap.6;5 Art 2713,Sec.25100 et seq and Title 22,Califomia Code of Regulations,Chap.20. PR0232494 2300-UNDERGROUND STORAGE TANK FACILITY 111/2003 To 1213112003 Underground Storage Tank Program, Califomia Health and SafetCode,Div.20,Chap.6.7 and Title 23,California Code of Regulations,Chap. 16_ ---- --------------------------- . - - ----- - ------ ------ --------------------- P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection 2362 1 390002324940249401 PT0004562 12,000 REGULAR UNLEADED Active,billable DOUBLE WALLED Continuous Intersellar Monitoring Underground storage Tank Permit Conditions I) 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 these Permit Conditions. 2) In order to maintain We 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 m any conditions established by San Joaquin County. 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 the Tank Owner and tank Operator receive a copy of the permit. 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Envinum emal Health Department(EHD)and are considerer]UST Permit Conditions. The approved monitoring,response,and plot plans slall be maintained onsite with the permit 5) The Pernm ee shall comply with the monitoring procedures referenced in this permit 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently ifspecified by the equipment manufacturer,and provide documentation of such servicing to this office. 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,An.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 of at least three years from the dale the monitoring was performed. 9) The EHD 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 of the UST system(including change in tank contents or usage),(fie Permit to Operate will be subject Ira review,modification or 11) LeSAW91bn,repair andlor removal permits are required from the EHD prior to any change,repair or removal of UST system equipment. 12) The Permittee shall submit an annual report documenting compliance with the UST Persil Conditions within 30 days of the anniversary date of the issuance ufthis permit. 13) This Permit to Operate shat l not be considered permission to violate any laws,ordinances or statutes of any other Federal.Slate or Local agency. 14) A"Conditional'Permit may be revoked if corrections specified on the inspection report are not completed by the dale(s) indicated. PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: KAISER PERMANENTE DBA: KAISER PERMANENTE (WEST LN) THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Regulated Facility KAISER PERMANENTE Facility ID FA0002602 7373 WEST LN AccountlD AR0004672 STOCKTON, CA 95210 Issued 7/22/2003 Billing Address: ATTN : ANNA MOSHER KAISER PERMANENTE 7373 N WEST LN STOCKTON, CA 95210 7023.rp1