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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DY&ARTMENT 304 E.WebQ Ave.,Third Floor•Stoclaon,CA 95202-2708•Phone(209)468-3420 Donna Heron, R.E.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 vand PR0518288 2300•UNDERGROUND STORAGE TANK FACILITY 5/1/2002 To 511/2002 Underground Storage Tank Program: California Health and Safety-Code Div.20,Chap.6.7 end TiBe 23 California Code of Regulations Chap.16---------------------------------- I ___________ Record Permit N capacity Contents Permit Status System Type Leak Detechon 2360 3 390005182880515629 PT0011950 20,000 PREMIUM UNLEADED Active,billable DOUBLE WALLED Continuous Inleonlow Martual g 2360 2 390005182880515628 PT0011949 20,000 REGULAR UNLEADED Active,billable DOUBLE WALLED Continuous Inlant8ial Monitaing 2362 1 390005182880515627 PT0011948 20,000 REGULAR UNLEADED Active,billable DOUBLE WALLED continuous Intersfillai Monitoring Underground Storage Tank Permit Conditions 1) 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) Io 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 m arty conditions established by San Joaquin County. 3) If the Tank Operator(t)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 lank,the Pennince shall ensure that both the Tank Owner and tack Operator receive a copy of the permit. 4) Written Monitoring Procedures and m Emergency Response Plat ma t be approved by the Environmental Health Depa ml(PRD)and ere cansidererd UST Permit Conditions. Tho approved monitoring,response,and plot plans shall be maintained onsite with the permit. 5) The Permittee shall comply with the monitoring procedures referenced in this permit. 6) The Pennines shall perform testing and preventive maintenance an all leak detection monitoring equipment annually,or more frequently if specified by the equipment manufacturer,and provide docomenlition of such servicing to this office. 7) In the event of a spill,leak,or other unauthorized release,the Families shall comply with the requirements of Title 23 CCR,Chap.16,Art.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 leas(tome years horn the date the monitoring was performed. 9) The FID shall be Pati fled of any change in ownership or operation of the UST system within 30 days of such Amp. 10) Upon my change in equipment,design or operation of the UST system(including change in lank contents or usage),the Permit to Operate will be subject to review,modification or r"eciak 11) Construction,repair and/or removal permits are required from the PER)prior to any change,repair or removal of UST system equipment. 12) The Permittee shall submit an arcual report documenting compliance with the UST Permit Conditions within 30 days of the anniversary date of the issuance of this permit. 13) This Permit to Operate shall not be considered permission to violate any laws,ordinances or entrants 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 TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: COSTCO WHOLESALE CORPORATION TINS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Regulated Facility: COSTCO GASOLINE FAC#0135* Facility'() FA0013810 3250 W GRANT LINE RD Account ID AR0023237 TRACY, CA 95376 Issued 9/20/2002 Gluing Address: ATTN : LICENSING COSTCO GASOLINE FAC#0135* 999 LAKE DRIVE ISSAQUAH, WA 98027 7023.mt