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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 Heron,RE-H.S.,Director ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE Program Permit Permit Record ID Number Program Code and Description Valid PRO514210 PT0010413 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/2003 To 12/31/2003 Hazardous Waste Generator Program: California Health and Safety Code,Div.20,Chap.6S,Art.2.13,Sec_25100 et seq,and Title 22,California Code of Regulations,Chap:20_ - ------- "'-- ---- -- PR0232494 2300-UNDERGROUND STORAGE TANK FACILITY 11112003 To '1213112003 Underground Storage Tank Program: California Health and Safety Code:Div.20,Chat).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 Intersbllal Monitoring Underground Storage Tank Permit Conditions 1) The Permit to Operate will become void if Annual Pem l 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 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 established by San Joaquin County. 3) tribe 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 Permince 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 mut be approved by the Environmental Health Department(EHD)and are considererd UST Pemut Conditions. The approved monitoring,response,and plot plans shall be maintained onam with the permit. 5) The Penninee shall comply with the monitoring procedures referenced in this permit.- 6) The Pennittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently ifspeci fied 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 Permilee 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 date the monitoring was performed. 9) The EHD shall be notified of any change in ownership or operation Oran 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),the Permit to Operate will be subject o review,modification or 1 I) LSY'iIS'iMlbn,repair and/or mmoval pemuLs 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 camp]iance with the UST Permit Conditions within 30 days of the anniversary dale of the issuance of this permit. 13) This Permit to Operate shall not be considered permission to violate any laws,ordinances or statutes of any other Federal,State or Local agency. 14) A"Conditional"Permit maybe revoked if corrections specified on the inspection report are not completed by the date(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 Accciunl ID AR0004672 STOCKTON, CA 95210 issued 51112003 Billing Address: KAISER PERMANENTE 7373 N WEST LN STOCKTON, CA 95210 7o23,rpt