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r SAN JUIN COUNTY PUBLIC HEALTI&KVICES <br /> 304 E. WEBER AVE., THIRD FLOOR • STOCKTON,CA 95202 NE (209)468-3420 <br /> KAREN FORST, M.D., M.P.H., HEALTH OFFICER <br /> DONNA HERAN, R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> ?FE TING PSIR IT FOR UNDERGROUND STORAGE TANK FACILITY <br /> Tank Tail. Permit Annual Permit Fee Valid <br /> PIP Number Record iD mum t r Capacity Contents Perm+t Status From To <br /> 2= ' — 006 TA504S02 UO748U Iona i Prem Unleaded O2 Conditional Permit 01/01/39 12/31/93 <br /> 2360 ON TA5048W 007451 12,000 Reg Unleaded 0-1- <br /> 2 Conditional Permit 01/01M 2/ <br /> 2360 005 TA504801 �v r .,1/99 <br /> J743_ 10,000 Midgrade Unleaded 0 Conditional Permit O1/O1/.�'9 12!31/;3 <br /> PERMIT CONDITIONS: <br /> 1) The PERMIT TO OPERATE will become void if ANNUAL PERMIT Fees and ER4ICE Fees are roll paid and/or the UST system(s) fail=_ <br /> to remain in compliance with, the PERMIT CONDITIONS. <br /> 2) The PERMIT TO OPERATE is granted to thre TANK OWNER who accepts responsibility for operating and monitoring the UST system <br /> according to S+.ate underground storage tank laws and regulations as well as any conditions established by Fan Joaquin County. <br /> ) The TANK CE'ERATOR(S), if different from the tank owner, shall Dperate and monitor the U'01 system according to the WRITTEN <br /> OPERATING AGREEMENT rewired under Section 25293, Chapter 6.7, Division 20, California Health and Safety Code. <br /> 4i Tree TANK OWNER shall notify the Environmental Health Division of any proposed charge in operation or ownership of the LIST <br /> system. <br /> 5> tkon any change in equipment, design or operation of this facility, the PERMIT TO OPERATE will be reviewed by the <br /> Environmental Health Division. <br /> 6) A construction or revival Permit is required from the Environmental Health Division prior to any removal or <br /> change of UST system equipment. <br /> 71 This PERMIT TO OPERATE shall not be considered permission to violate any existing laws, ordinances or statutes of other <br /> federal, state or local agencies. <br /> pi A "Conditional Permit" may be revoked if corrections are not completed by the date(s) specified on inspection. <br /> PERMIT TO OPERATE an tp_T FACILITY issued to: r'AI DCI, 0 <br /> AN JOSE, C:A 9.5111 <br /> F'E MTT=; TO OPERATE n-f-Ir ANNUAL PERMIT FEE PAYMENT" c;e NOT TRAN"'ERABL E <br /> and rr,ay be _.1 IM PENDED ;.r REVOk::ED f c r c aL;se . <br /> THIS, FORM MVST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> "E"vfjLATED FACILITY; FA'_,T GAS Account ID: 0007692 <br /> ...=,50 E 4JATERLOi i RD Facility IO: 006343 <br /> '=TOCk;TO-N . CA 9.505 Permit Printed. 04/26/95 <br /> SILL ING ADDRESS: FA=,.'T CAS* <br /> ATTR! KIIIAl DCI <br /> 681 DOTEY CT <br /> CAN 3C' E, CA 9.5, 11 <br />