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SAN JW N COUNTY PUBLIC HEALTH "*`VICES <br /> P O Box 3881%.o�SrocKToN, CA 95201-0388 • PaoN. "r^ 468-3420 <br /> ERNEST M. FUIIMOTO, M.D., M.P.H., ACTING HEALTH OFFICER <br /> DONNA HERAN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH ' <br /> OPERATING PERMIT FOR UNDERGROUND STORAGE TANK FACILITY <br /> ?art, Tank Pe*u <br /> uat Annual Permit Fee Valid <br /> P!E MAber Record ID (lumber CaraEity__ Contents Permit Status _ From To <br /> 725.0 00 TAIS3201 004114 10,000 Unleaded 01 Active Permit <br /> 2380 002 TA15:3202 004120 10,000 Unleaded 01 Active Permit. 01/01/95 12/31/95 <br /> 2:384 003 TA153203 004121 4,OC?; Unleaded 01 Active Permit 01/01195 12/31195 <br /> PERMIT CONDITIONS: <br /> 1) The PERMIT TO OPERATE will beco&e void if AWMAL PERMIT Fees and SERVICE Fees are not paid andtor the LIT system(s) fails <br /> to remain in EMPEance with the PERMIT CONDITIONS. <br /> 2) The PERMIT TO OPERATE is granted to the TANK (09 who accepts responsibility for operating and monitoring the UST system <br /> according to State underground storage tank laws and reguiations as well as any conditions established by San 1oaa in County <br /> 3; The TANK OPERATOR(S), if different from the tank owner, shall operate and monitor the UST system according to the VNTITTB <br /> OPERATING A IEEMENT required under Section 25243, Chapter 6.7, Division 20, California Health ana Safety Cede, <br /> 41 The TAN' OM shall ratify the Environmental Health Division of any proposed change in operation or ownership of the UST <br /> system. <br /> 5? Vpon any change in equipment, design or operation of this facility, the P17tMIT TO OPERATE will be reviewed by the <br /> Environmental Health Division. <br /> 5) A construction or removal permit is required from the Environmental Health Division prior to any removal or <br /> change of UST system equipment. <br /> 7) This PERMIT TO OPERATE shall not tae considered permission to violate any existing laws, ordinances or statutes of other <br /> federal, state or local agencies. <br /> PERMIT TO OPERATE an UST FACILITY issued to; CIRCLE K; CORP <br /> PO SOX 52084 <br /> PHOENIX , AZ 8507 <br /> PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br /> and maybe SUSPENDED or REVOKED for cause . <br /> THIS FCC" MUST BE DISPLAYED COPISPICUC#.fSLY ON THE PROMISES- <br /> 4: P s <br /> REWLATEDFACILITY; CIRCLE K: ;_,TITRE #1L05 Account. 1D; 0000184 <br /> 16470 CAMBRIDGE Facility ID; 00013.5 <br /> LATHROP, CA 95330 Permit Printed: 0:E i'?1l15 <br /> 51LLING' ADDRESS: <br /> CIRCLE 1-:: STORE #1205 <br /> ATTN ; CIRCLE K STORE': INC: <br /> PO BOX S20; 5 <br /> PHOEN-1X Z ='-E67 <br />