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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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2300 - Underground Storage Tank Program
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PR0231532
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BILLING_PRE 2019
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Entry Properties
Last modified
10/4/2022 2:28:59 PM
Creation date
11/2/2018 3:58:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0231532
PE
2351
FACILITY_ID
FA0000185
FACILITY_NAME
CITY FOOD & LIQUOR
STREET_NUMBER
16470
STREET_NAME
CAMBRIDGE
STREET_TYPE
ST
City
LATHROP
Zip
95330
APN
19643032
CURRENT_STATUS
03
SITE_LOCATION
16470 CAMBRIDGE ST
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\C\CAMBRIDGE\16470\PR0231532\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
10/23/2012 8:00:00 AM
QuestysRecordID
132740
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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SAN JOAN N COUNTY PUBLIC HEALTH P- RVICES <br /> P O Box 388 'r-'STOC% ToN, CA 95201-0358 • PHorILi�„_,9) 468-3420 <br /> ERNEST M. FWIMOTO, M.D., M.P.H., ACTING HEALTH OFFICER <br /> DONNA RERAN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> OPEPATINIG PERMIT FOR UN —R6RLXM STORAGE TAW FACILITY <br /> Tank Tai Permit AnDuai Permit tee Valid <br /> HE ik>aiGerRecord ID <br /> _ Number Capacity Contents Permit Status _ From To <br /> 7C0 t1x)l , TAIS3201 0041,19 10,00<) hnleaded 01 A.Etive Permit 01/01/97 12/31/97- <br /> 2380 002 TAIS3202 004120 10,000 Unleaded 01 Active Permit 01/01/97 12/31/97 <br /> 2380 003 TA153203 004121 4,000 Unleaded 01 Active Permit 01/01/97 12/31/97 <br /> PERMIT CONDITIONS: <br /> 1) The PERMIT TO OPERATE will become void if AWIW4lAL PERMIT Fees and SERVICE Fees are laat paid arid/or the L!Sf system(s) fails <br /> to remain in compliance with the PERMIT COWITIOR3. <br /> 2) The PERMIT TO OPERATE is granted to the TAPIR 'WR who accepts responsibility for operating and monitoring the UST system <br /> according to State underground storage tank laws and regulations as well as any conditions established by San Joaquin Cxamty. <br /> S) The TAW. OPERATOR(S), if different from the tark owner, shall operate and monitor the UST system according to the VAITTEN <br /> OPERATING AGREEMENT required under Section 25293, Chapter 5.7, Division A, California Health and Safety Code. <br /> 4) The TANk DINER shall notify the Environmental Health Division of any proposed charge in operation or ownership c4 the UST <br /> system. <br /> 5) Upon any change in equipment, design or operation of this facility, the PERMIT TO OPERATE will be reviewed by the <br /> Environmental Health Division. <br /> o) A construction or removal permit is required from the Envirormental Health, Division prior to any removal or <br /> change of UST system equipment. <br /> 7) This PERMIT TO OPERATE shall not be considered permission to violate any existing laws, ordinances or statutes of other <br /> federal, state or local agencies.. <br /> PERMIT TO OPERATE an V"3T FACILITY issued to: CIRCLE K CORP <br /> 601 UNION ST '?TE 2500 <br /> =;EATTLE, WA 98101 <br /> PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE / <br /> and may be SUSPENDED or REVOKED fGr cause . <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES / <br /> RELATED FACILITY; CIRCLE P': STC ARE #1205 Account ID; 0000184 <br /> 0470 CAMBRIDGE t Facility ID: OW185 ; <br /> L.ATHROP, CA 95330 Permit Printed: 03/28/97 <br /> BILLING ADDRESS. CIRCLE P:: STORE #12015 I <br /> ATTW CIRCLE K. :;TORE_ INC <br /> PO BOX S2108S <br /> PHOENIX , AZ 1-5�=�72 <br /> � A.d <br />
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