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ti � v SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E.Weber Ave.,Third Floor•Stockton,CA 95202-2708•Phone(209)468-3470 Dona Heran,REH.S.,Director ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE Program Permit Permit Record ID Norther Program Code and Description /did PRO521716 PT0014673 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/2004 To 12(31/2004 Hazardous Waste Generator Program* In order to maintain the permit to operate,Hazardous Waste Generators shall comply With California Health and Safety Code,Div.20,Chap.6.5,Art 2-13, Sec,25100 et seq,and Title 22,California Code of Regulations,-Chap-.-2-0 PR0231532 2300-UNDERGROUND STORAGE TANK FACILITY 1//2004 To 12/31/2004 Underground Storage Tank Program* California Health and Safety Code,Div.20,Chap.6.7 and Title 23,California Code of Re�ulatlons,Chap:16_ P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection 2362 4 390002315320506754 PT0009046 12,000 REGULAR UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial monitoring 2360 5 390002315320506755 PT0009045 12,000 PREMIUM UNLEADED Active,billable DOUBLE WALLED Continuous Interstitial Monitoring Underground Storage Tank Permit Conditioms 1) The Permit to Operate will become void if Annual Permit Fees and Service Fees are not paid and/or the UST systems)fails to remain in compliance with these Permit Conditions. 2) In order to maintain the operating pemut,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) If the Tank Operators)is different from the Tank Owner,or if the Permit m Operate is issued to a person other than the owner m operator of the tank,the Permittee shall ensure that both the Tank Owner and rank Operator receive a copy of the permit. 4) Written Monitoring Procedures and an Emergency Response Plan most be approved by the Environmental Health Department(EHD)and are considererd UST Pemdt Conditions. The approved monitoring.response,and plot plans shall be maintained onsite with the permit 5) The Pemdtme shall comply with the monitoring procedures referenced in this pemut 6) The Permitee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more fi squently if specified 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,Am 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 Elm 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),the Permit to Operate will be subject to review,modification or l l) Cd'85i'd(glb4 repair and/or removal permits are required nun 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 Permit Conditions within 30 days of the date of the issuance of this pemdt 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 may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated- PERMITS ndicatedPERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: CIRCLE K STORES INC DBA: CONOCOPHILLIPS COMPANY THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Regulated Facility CIRCLE K STORE#1205 FacilityID FA0000185 16470 CAMBRIDGE ST Account ID AR0000184 LATHROP, CA 95330 Issued 4/1/2004 Billing Address: ATTN : LICENSING DEPT DC-36 CIRCLE K STORE #1205 PO BOX 52085 PHOENIX, AZ 85072-2065 7o23.rpt