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<br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
<br />1868 E. Hazelton Ave. • Stockton, CA 95205-6232 • Phone (209) 468-3420
<br />Donna Heran, R.E.H.S., Director
<br />ENVIRONMENTAL HEALTH
<br />SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br />PERMIT TO OPERATE
<br />Program Permit - Permit
<br />Record ID Number Program Code and Description Valid
<br />In order to maintain the permit to operate, Hazardous Waste Generators shall comply with California Health and Safety Code, Div. 20, Chap. 6.5, Ad. 2-13,
<br />Sec. 25100 at seq and Title 22 ornia Code of Regulations, Chap. 20, ,
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<br />PR0518624 2300 - NDERGROUND STORAGE TANK FACILITY 1/1/2013 To 1213112013
<br />Underground Storage Tank ro ra .
<br />California Health and Safety , Div. 20, Chap. 6.7 and Title 23, California Code of Regulations, Chap. 16.
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<br />P/E Tank # Tank Record ID Permit # Capacity Contents Permit Status SystemTypc Leak Detection
<br />2372 1 390005186240515648 PT0012148 20,000 REGULAR UNLEADED Active, billable DOUBLE-WALL Continuous Interstitial Monitoring
<br />2370 2 390005186240515649 PT0012149 20,000 REGULAR UNLEADED Active, billable DOUBLE-WALL Continuous Interstitial Monitoring
<br />2370 3 390005186240515650 PT0012150 20,000 PREMIUM UNLEADED Active, billable DOUBLE-WALL Continuous Interstitial Monitoring
<br />BOE ID#: 44039100
<br />Underground Storage Tank Permit Conditions
<br />I) The Permit to Operate will became 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.
<br />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
<br />established by San Joaquin County.
<br />3) If the Tank Operators) is different from the Tank Owner, or ifthe Permit to Operate is issued to a person other than the owner or operator of the tank, the Pemtince shall ensure that both
<br />the Tank Owner and tank Operator receive a copy of the permit.
<br />4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Environmental Health Department (EHD) and are considererd UST Permit Conditions. The approved
<br />monitoring, response, and plot plans shall be maintained onsite with the permit.
<br />5) The Perminee shall comply with the monitoring procedures referenced in this permit.
<br />6) The Permittee shall perforn testing and preventive maintenance on all leak detection monitoring equipment annually, or more frequently if specifiedby the equipment manufacturer, and
<br />provide documentation of such servicing to this office.
<br />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, Art. 5, and the approved Emergency Response Plan,
<br />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
<br />performed
<br />9) The EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change.
<br />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
<br />revocation.
<br />1 I) Construction, repair and/or removal permits me required from the EHD prior to any change, repair or removal of UST system equipment.
<br />12) This Permit to Operate shall not be considered permission to violate any laws, ordinances or statutes of any other Federal, State or Local agency.
<br />13) A "Conditional' Permit may be revoked ifconnections specified on the inspection report are not completed by the date(s) indicated.
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<br />PERMITS TO OPERATE may be SUSPENDED or REVOKED for cause.
<br />PERMIT(s) Valid only for: COSTCO WHOLESALE CORPORATION
<br />DBA: COSTCO
<br />THIS FORM MAST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES }
<br />Regulated Facility.
<br />COSTCO WHOLESALE #38 Facility ID FA0001705
<br />,
<br />1616 E HAMMER LN Account l0 AR0001704
<br />STOCKTON CA 95210 Issued 2/19/2013
<br />Billing Address: ATTN : LICENSING
<br />COSTCO WHOLESALE.#38
<br />PO BOX 35005
<br />SEATTLE WA 98124-3405
<br />7023rpt
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