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SAN JOA01N COUNTY PUBLIC HEALTH VICES 304 E.WEBER AVE.,THIRD FLOOR - STOCKTON,CA 95202 - PHONE (209) 468-3420 KAREN FURST M.D., M.P.H., HEALTH OFFICER DONNA RERAN, R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE ermit Valid rogram ertnrt Record ID Number Program Code and Description 111100 To 12/31/00 PR023156 2300-UNDERGROUND STORAGE TANK FACILITY Underground Storage Tank Program: California Health and Safety Code Div.20,Chap.6.7 and Title 23 California Code of Regulations Chap. 16. - - - ype - - _ - - - - an- ecor - - - - erne apace on ens PermitStatus ys em c ive UNLEADED Active DOUBLE WALLED 2360 5 390002315630505784 PT0008310 12,000 UNLEADED Active DOUBLE WALLED 2360 6 390002315630505785 PT0008309 6,000 BOE-ID#: 44-024759 '11 , . Underground Storage Tank Permit Conditions 1) 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 these Permit Conditions. 2) In order to maintain the operatingpermit,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 18,as well as any conditions established by San Joaquin County. 3) If the Tank Operator(s)is different from the Tank Owner,or if the Permit to Operate 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. and are ri 4) UWritten ST permitMonitorinIg Procedures Copies of an the Procedures and EmergeRes onse tan must be ncy Response PIanemust bethe attached oethis lHealth permit or be aovailable forlrevrew and/or inspection j) �th UST site. IreePermittee shall comply with the monitoring procedures referrenced in this permit. 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently if specified 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 Permitee shall comply with the requirements of Title 23 CCR Chap. 16,Art.5,and the approved Emergency Response Plan. med for froit the date f all monitoring o monitoring was pe formed shall be maintained on-site by the operator and be available for inspection for a period of at least three years 8) Written records 9) The PHS/EHD shall be notified of any change in ownership or operation of the UST system within 30 days s such change. 10) Upon any change in equipment,design or operation o f the UST system (including change in tank contents or usage),the Permit to Operate will be subject to review,modification or revocation. 11) Construction,repair and/or removal permits are required from the PHS/EHD prior to any change,repair or removal of UST system equipment. the UST Permit Conditions within 30 days of the anniversary date of the issuance 12) The Permittee shall submit an annual report documenting compliance with of this permit. 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. 14) A"Conditional"Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. PERMITS TO OPERATE are NOT TRANSFERABLE r and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: FISK, JAMES L DBA: J & L MARKET THIS FORM MUST BE DISPLAYED CONSPICUOUSLI'ON THE PREMISES Facility ID FA0000110 Regulated Facility: J & L MARKET* Account ID AR0000109 8115 S ELDORADO ST Issued 912812000 FRENCH CAMP, CA 95231 Billing Address: ATTN : JAMES L FISK FISK, JAMES L PO BOX 147 FRENCH CAMP, CA 95231 7023.rpt