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SAWAQUIN COUNTY PUBLIC HEANH SERVICES <br /> + P O Bo • SrocKToN, CA 95201-0388 • oNE (209) 468-3420 <br /> ERNEST M. FUJIMOTO, M.D., M.P.H., ACTING HEALTH OFFICER <br /> DONNA HERRN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> DATING PERMIT FOR UNDERGROUND S-r'DRAGE TAN111 FACILITY <br /> Tank Tank Permit Annual Permit Fee Valid <br /> PIE Number Record ID Number Capacity_ Contents Permit Status From To <br /> 2380 001 TA13W1 003654 1019- Unleaded 42 Conditional Permit 41/01/36 12/31/36 <br /> 2380 002 TA135802 003661 101009 Unleaded 02 Coalitional Permit 01/01/`_16 12/31/36 <br /> 2380 :))3 TA1.35843 003662 10,000 Unleaded 42 Conditional Permit 01/41f36 12/31/96 <br /> PERMIT CONDITIONS: <br /> li The PERMIT TO OPERATE will become void if ANNUAL PERMIT Fees and SERVICE Fees are It paid and/or the tPT system(s) fails <br /> to remain in compliance with the PERMIT CONDITIONS. <br /> 2) The PERMIT TO OPERATE is granted to the TANK' OWNER 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 Sar Joaquin Courts. <br /> 3) The TANK OPER.ATOR(S), if different from the tank owner, shall operate and monitor the UST system, according to the WRITTEN <br /> OPERATIM AGREEMENT required under Section 25243, Chapter 6.7, Division 20, California Health and Safety Code. <br /> 4) The TANK OWNER shall notify the Environmental Health Division of any proposed change in operation or ownership of the UST <br /> system. <br /> 5i Upon an'y change in equipment., lesign ar operatim of this facility, tfe PERMIT TO CERATE will be reviewed by the <br /> Environmental Health Division. <br /> 61 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 be considered permission to violate any ffxisting laws, ordinances cm statutes of diner <br /> federal, state or local agencies. <br /> S) A "Conditional Permit" may be revoked if correct.io are not ccmplet.ed by the date(s) specified on inspection. <br /> PERMT TO OPERATE an UST FACILITY issued to; M B P <br /> 2191 NAVY OR <br /> ;TOCKTiiN, CA qr= ,C16 <br /> PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br /> and rf a,Y be SUSPENDED c,r REVOKED f c r cause . <br /> HIS FORM MUST BE DISPLAYED CONSPICUOUSLY OUSLY dam! THE PREMISES <br /> REGULATED FACILITY; M B P Account ID; 0-3168 <br /> SOi W LODI AVE Facility ID; OOK:913 <br /> LODI . CA 95240 Permit Printed; 08/19./46 <br /> BILLING ADDRESS: BOK 1DE,=;, MEL <br /> ATTN: MEL BOKIDE'= PETROLEUM <br /> 2191 NAVY DR <br /> STOCKTON, CA 9G206 <br />