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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E.Weber Ave.,Third Floor• Stockton,CA 95202-2708 0 Phone(209)468-3420 Donna Heran,R.E.H.S., Director ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGEN Y PERMIT TO OPERATE Program Permit Permit Record ID Number Program Code and Description Valid PRO518454 PT0012031 2220-SMALL QUANTITY HAZARDOUS WASTE GENERAT/FA 111/2003 To 12/31/2003 Hazardous Waste Generator Program: California Health and Safe Code,Div.20,Chap._6.5,Art.2-13,Sec.25100 et seq,and TitCode of Regulations,Chap.20_ _______________--------------- - 4 ------ ---- PR0231948 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/2003 To 12/31/2003 Underground Storage Tank Program: California Health andSafe Code,Div.20,Cha 6.7_and Title 23,_California Code_of Regu6-------------------------------------------------------------- P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection 2360 6 _390002319480194806 PT0005203 10,000 MIDGRADE UNL ED Active,billable DOUBLE WALLED Continuous Interstitial Monitoring 2360 5 3900 319480194805 70005202 10,000 REGULAR UNL DED Active,billable DOUBLE WALLED Continuous Interstitial Monitoring 2362 3900 31948019480 0005201 10/Fees 000 PREMIUM UN DED Active,billable DOUBLE WALLED Continuous Interstitial Monitoring U erground torage Ta ermit Conditions ;1) The ji erste will become void ifAnnual Permit Fees aice Fees are paid and/or the UST system(s)fails to remain in compliance with these Permit Conditions. 2) In order to maintain the operating permit,the owner and operator sly with &S Code,Div.20,Chap.6.7 and 6.75;and CCR,Title 23,Chap.16 and 18,as well as any conditions established by San Joaquin County. 3) Ifthe Tank Operator(s)is different from the Tank Owner,or if tit to rate is issued to a person other than the owner or operator of the tank,the Permittee shall ensure that both the Tank Owner and tank Operator receive a copy of the permit.4) Written Monitoring Procedures and an Emergency Response Plan p ved by the Environmental Health Department(EHD)and are considererd UST Permit Conditions. The approved monitoring,response,and plot plans shall be maintained onsite witL5) The Permittee shall comply with the monitoring procedures referenis permit.6) The Permittee shall perform testing and preventive maintenanceak detection monitoring equipment annually,or more frequently ifspecified by the equipment manufacturer,and provide documentation of such servicing to this office.7) In the event of a spill,leak,or other unauthorized release,the PFkhall 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 maintain on-site by the operator and be available for inspection for a period of at least three years from the date the monitoring was performed. 9) The EHD shall be notified of any change in ownership or tion of the UST system within 30 days of such change. i 10) Upon any change in equipment,design or operation oft UST system(including change in tank contents or usage),the Permit to Operate will be subject to review,modification or m 11) MffAi lbn,repair and/or removal perits are requ. d m the EHD prior to any change,repair or removal of UST system equipment. 12) The Permittee shall submit an annual report documi ting compliance with the UST Permit Conditions within 30 days of the anniversary date of the issuance of this permit. 13) This Permit to Operate shall not be considere,4pe ission to violate any laws,ordinances or statutes of any other Federal,State or Local agency. 14) A"Conditional'Permit may be revoked' co ctions specified on the inspection report are not completed by the date(s) indicated. PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PER T(s)Valid only for: USA PETROLEUM CORP Tank Owner: USA GASOLINE#3696 THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Regulated Facility: I A GASOLINE#3696 Facility ID FA0003855 448 W KETTLEMAN LN Account ID AR0003443 LODI, CA 95240 Issued 511/2003 Billing Address: USA GASOLINE #3696 30101 AGOURA CT #200 AGOURA HILLS, CA 91301 7023.rpt