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SAN *QUIN COUNTY PUBLIC HEALSERVICES <br /> P O Box 388 • STOCICPON, CA 95201-0388 • PFWNE (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 /> OPERATING PERMIT FOR q,. GR10L STORAGE TAW FACILITY <br /> Tank Tank pertnit Annual Permit Fee 'valid <br /> P/E Number Record T Number CaP.acity Contents _ Permit Status <br /> From __� 4` <br /> r i OOi T 113101 fr 51.9 ,OCv Leaded ondi lona. ermit. 0,101 s17 <br /> z3ff) 002 TA119102 005110 Sf'al Unleaded O2 Conditional Permit U110ii45 1:,'31/45 <br /> 2^£A 003 TAii4103 005111 t,cp0 Diesel 02 Conditional permit Oi/Oi/95 i2/31/4S <br /> PERMIT CONDITIONS : <br /> 1) The PERMIT TO OPERATE will beccxge void ;f ANNUAL PERMIT Fees and SERVICE Fees are not. paid and/or the i1 T system(s) fails <br /> to remain in compliance wilt; the PERMIT tNDITIONS. <br /> 2) The PERMIT TO OPERATE is granted to the TANK OWER who a.cepts resFcrosibilit.y for operating and monitoring the LIST s' stem <br /> acc.-irding to State underground storage tank laws and regulations as well as any conditions established by San 3o3quin County. <br /> ;i The TANK OPERATC�k(S), if different from the tanb: owner, snail operate and monitor the UST system according to the i4RITTEN <br /> OPERATING AMEEMENT required under Section 2U333 Chapter t,.7, Divisir_m 20, California Health and Safety Code. <br /> 4) The TANS, EIMER shall notify the Environmental Health Division of any proposed change irj operation or ownership of the U-1 <br /> Sys,eem. <br /> S) I"' n any change in equipment, design or operation of this far 1, the PERMIT TO OPERATE will be revi,wed 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 /> g) A "Corditional Permit" ma) be revoked if correction~ are rN?t crfgipleted by the date(s) specified on inspection. <br /> # + # # # # # <br /> PERMIT TO OPERATE an U=T FACILITY issued to, i-OC:AL F01-10 STORE #1 <br /> 26SO MOUNT DIABLO '=*T <br /> gT(C"KTON, CA ar.,_0 <br /> PERMIT} TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause . <br /> THIS FCS RT DE DI'SpLAyED COW:ppIC%KAjSLY ON THE F'REMISFS <br /> REGULATED FACTLIT; LOCAL FOOD STORE #1 Account IO; 0003421 <br /> Facility ID: {ip D-31 , <br /> , CA 9q-202 <br /> 65x0 MNDIABLO '_T Fermlt Printed; OS/'11./9.5 <br /> BILLING ADORES; <br /> LOCAL. FOOD '=TORE #1 <br /> ATTW MASOOD, K:HALID <br /> ,SO MONTE DIABLO :_.T <br /> .;Ti_IC:)CTON, CA 95-:0: <br />