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1 SAN JOIN COUNTY PUBLIC HEALTHARVICES f 304 E.WEBER AVE.,THIRD FLOOR • STOCKTON,CA 95202 • PHONE(209) 468-3420 KAREN FURST,M.D.,M.P.H.,HEALTH OFFICER DONNA HERAN.R.E.H.S.,DIRECTOR ENVIRONMENTAL HEALTH DIVISION ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY TO OPERA Y CERTIFIED UNIFIED E PROGRAM AGENCY Permit Valid Program prnnd program Codeand Description Record m Number 111101 To 1213110'1 PR0231868 2300-UNDERGROUND STORAGE TANK FACILITY Underground Storage Tank Program_ California Health and Safe Code Dtv.20,Cha 6.7 and Title 23 California Code of Re ulaliPertnit Stams6 System Type Leak Detection P_ --- —— 9 --- -- -- Pertntt# papa y Contrnts P/E Tank# Tank Record ID DED Acttve gOUBLE WALLED LINE 1 SS TEST 2362 2 390002318680505529 PT0008087 10,000 KC BOE IDk` 44=03191477 Underground Storage Tank Permit Conditions 1) The Permit to Operate win become void if Annual Permit Fees and Service Foes are not paid an Nor the U ST syskm(s)fails to remain in compliance with these Permit R,Title 23,Chap. 16 and 18,as we as Conditions. 2) In order tt maintain the operating permit,the permit holder shall comply with the H&S Code,Div.20,Chap.6.7 and 6.75;and CC any conditions established by San Joaquin County. 3) If the Tank Operators)is different from the Tank Owner,or if the permit to Operate is issued to a person other than the owner or openUor of the tank,the Pemrittce shall ensure that both the Tank Owner and tank Operator receive a copy of the permit. 4) Written Mo,itroring Procedures and an EmeBcocy Response Plan must be app roved by the Environmental Health Divaion(PHSBHD)andare considererd UST Permit Conditions. Copies of the Procedures and Emergency Response Plan must be attached to this permit or be available for review and/or inspection at the UST sits emit. 5) The Permittee shall comply with the monitoring procedures wfenmriced in this p 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently if specified by the equipment manu factmr,and provide documentation of such servicing to this office. 7) In the event of a spill,leak,or other unauthorized release,the permits 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 least three}ears from the date the monitoring was performed. 9) The PHS/EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such c ange. 10) Upon any change in equipment,design or operation of the USr system(including change in tank contents or usage),the permit to Operate will be subject to review, modification or revocation. 11) Construction,repair and/or removal permits are required from the PHS/EHD prior to any change,repair or removal of UST system equipment. 12) The Permittee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the anniversary date of the issuance ofthis permit. 13) This Permit to Operate shall not be considered permission to violate any laws,ordinances or statutes 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 dates) indicated. PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: PACIFIC BELL ENVIRONMENTAL MGT DBA: PACIFIC BELL Tank Owner: PACIFIC BELL THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Facility ID FA0004045 Regulated Facility: PACIFIC BELL Account ID AR0003691 4051 NEWTON RD Issued 3/29/2001 STOCKTON. CA 95205 Billing Address: ATTN : ENVIRONMENTAL MGMT PACIFIC BELL PO BOX 5095 RM 3E000T SAN RAMON, CA 94583-0995 • @3.rpt 0