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SAN JOIN COUNTY PUBLIC HEALTH &VICES <br /> 304 E.WEBER AVE.,THIRD FLOOR • STOCKTON,CA 95202 • PHONE(209) 468-3420 <br /> KAREN FURST, M.D., M.P.H., HEALTH OFFICER <br /> DONNA RERAN,R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> t <br /> Valid <br /> rogramPermit Program Code and Description <br /> Record lD Number g 111100 To 12131100 <br /> PR023122 2300-UNDERGROUND STORAGE TANK FACILITY <br /> Underground ct race Tank Program: <br /> California Health and Safety Code Div.20,Chap_6.7 and Title 23 California Code of Regulations Chap. _ _-ys em yp <br /> " cive <br /> UNLEADED Active DOUBLE WALLED <br /> 2360 6 390002312270505680 PT0008225 12,000 UNLEADED Active DOUBLE WALLED <br /> 2360 5 390002312270505679 PT0008224 12,000 <br /> BOE'ID#:"44-024594::==.�,�, <br /> Underground Storage Tank-Permit <br /> I) 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 <br /> these Permit Conditions. <br /> 2) In order to maintain the operating pem it,the permit holder shall comply with the H&S Code,Div.20,Chap.6.7 and 6.75;and CCR,Title 23,Chap. 16 an <br /> 18,as well as Pany conditions established by San Joaquin County. <br /> s issued to 3) If <br /> re Tankm[ttee shall rano ensure is differ the Tank Owner and inResert or if the Pe sive it zOper toopy the permit a person other than the owner or operator of the tank,the <br /> Health <br /> 4) Written UST Penni itondgiPrLo�Copes and iin e Proceduressidererd <br /> gand Fmergerise lan must be ncy Resporrse Plan mus[beattachedroethislpermit oDrbesaaiable for�revr review and/orare �nspection <br /> tU T ttee ssite. <br /> 5) �heh�'err�uhall comply with the monitoring procedures referrenced in this permit. <br /> 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently if specified by the <br /> equipment manufacturer,and provide documentation of such servicing to this office. <br /> 7) In the event of a spill,leak,or other unauthorized release,the Pecnitee shall comply with the requirements of TnIe23 CCR Chap. 16,Art.5,and the <br /> approved Emergency Response Plan. <br /> 8) Written retards 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 <br /> from the date the monitoring was performed. <br /> 9) The PHS/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 subjecttff <br /> review,modification or revocation. <br /> 11) Construction,repair and/or removal permits are required from the PHS/EHD prior to any change,repair or removal of UST system equipment, <br /> 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 <br /> of this permit. <br /> 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. <br /> 14) A"Conditional'Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for. TOSCO NORTHWEST CO <br /> DBA: CIRCLE K STORES <br /> Tank Owner: CIRCLE K STORES INC <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facility ID FA0004033 <br /> Regulated Facility: CIRCLE K STORES INC#5449' Account ID AR0003673 <br /> 7647 PACIFIC AVE Issued 912912000 <br /> STOCKTON, CA 95207 <br /> Billing Address: ATTN : LICENSING DEPT DC36 <br /> TOSCO NORTHWEST CO <br /> PO BOX 52085 <br /> PHOENIX, AZ 85072-2085 <br /> 7023.rpt % 41 <br />