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Environmental Health - Public
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EHD Program Facility Records by Street Name
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WATERLOO
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6732
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2300 - Underground Storage Tank Program
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PR0231830
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BILLING
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Entry Properties
Last modified
7/6/2020 4:37:43 PM
Creation date
11/7/2018 12:45:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
RECORD_ID
PR0231830
PE
2361
FACILITY_ID
FA0004030
FACILITY_NAME
THREE PALMS GROCERY
STREET_NUMBER
6732
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
10110001
CURRENT_STATUS
02
SITE_LOCATION
6732 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\IAError\W\WATERLOO\6732\PR0231830\BILLING.PDF
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EHD - Public
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SAN JOAN TIN COUNTY PUBLIC HEALTH ` RVICES <br />P O Box 388 � SrocKToN, CA 95201-0388 • PHOWN209) 468-3420 <br />ERNEST M. FUJIMOTO. M.D.. M.P.H.. ACTING HEALTH OFFICER <br />DONNA HERAN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br />01PERATIKZ PERMIT FOR .RGRLk-:STC-RAGE TAN' FACILITY <br />Tank <br />Tank <br />Permit <br />Annual Permit <br />Fee Valid <br />P/E Number <br />Record iD <br />timber capacity Contents <br />Permit Status From <br />To <br />2360 002 <br />_ <br />TA183002 <br />006543 11000 unleaded <br />01 Active Permit 01/01/97 <br />12/31/97 <br />2360 005 <br />TA18300S <br />006556 1.W unleaded <br />01 Active Permit 0/101/97 <br />12/31/97 <br />PERMIT CONDITIONS: <br />1) The PERMIT TO OPERATE will become void if ANNUAL PERMIT Fees and SERVICE Fees are not paid and/or the VST system(s) fails <br />to remain in compliance with the PERMIT CONDITIONS. <br />2) The PERMIT TO OPERATE is granted to the TANK WER 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 San Joaquin County. <br />3) The TANK OPERATOR(S), if different from the tank owner, shall operate and monitor the UST system according to the WRITTEN <br />OPERATING AGREEMENT required under Section 25293, Chapter 6.7, Division 20, California Health and Safety Code. <br />41 The TANK O6W. shall notify the Environmental F6alth Division of any proposed change in operation or ownership of the UST <br />system. . <br />6) Upon 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 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 existing laws, ordinances or statutes of other <br />federal, state or local agencies. <br />PERMIT TO TERAtic an UST FACILITY issued to: BOZZANO, LINO <br />2891 N ARA.TA RD <br />STOCI:.TON, CA 952,05 <br />PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENT:' are NOT TRANSFERABLE <br />and may be SUSPENDED c r REVOKED far c mase . <br />THIS !FORM WJST BE DISPLAYED CONWICLKXJSLY ON THE PREMISES <br />RE-GLATED FACILITY: THRE=7 RAL; CRA,`ERY Account 10. OW3669 <br />,ka32 E HWY Be Facility IDs 004030 <br />STOCI::TON, C.A 352 15 Permit Printed; 03/28/97 <br />BILLING ADDRESS: THREE PALMS GROCERY <br />ATTN: (307ZANO, LING <br />2891 N ARATA RD <br />STOCKTON, CA 9S20S <br />L.,�C <br />
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