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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 1868 E.Hazelton Ave. • Stockton,CA 95205-6232 • Phone(209) 468-3420
<br /> Donna Heran,R.E.H.S.,Director
<br /> ENVIRONMENTAL HEALTH
<br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br /> PERMIT TO OPERATE
<br /> Program Permit Permit
<br /> Record ID Number Pro Code and Description Valid
<br /> PRO513740 PT0009935— 220- MALL-QUANTITY-HAZAR_DOUS-WASTE-GENERATOR-FACIDT, — — 11112013 To-12f3112013-
<br /> Hazardous Wase General Pro r
<br /> In order to maintain the peit t Aerate, Hazardous Waste Generators shall comply with California Health and Safety Code,Div.20,Chap.6.5,Ad.2-13,
<br /> Sec.25100 et seand and Titl ,California Code of Regulations,Chap,20:
<br /> PR0231211 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/2013 To 12/31/2013
<br /> Underground Storage Tank Program:
<br /> California Health and Safety Code, Div. 20,Chap,6.7 and Title 23, California Code of Regulations,Chap_16.
<br /> ---....__._ .. ------ ..---- -- - ---------_----- -------------------- ---- .............................................................
<br /> P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Dctecbon
<br /> 2372 10 390002312110515704 PT0014868 20,000 REGULAR UNLEADED Active,billable DOUBLE-WALL Continuous Interstitial Monitoring
<br /> 2370 11 390002312110515705 PT0014869 10,000 DIESEL Active,billable DOUBLE-WALL Continuous Interstitial Monitoring
<br /> 2370 12 390002312110515706 PT0014870 10,000 PREMIUM UNLEADED Active,billable DOUBLE-WALL Continuous Interstitial Monitoring
<br /> BOE ID#: 44040801
<br /> Underground Storage Tank Permit Conditions
<br /> I) 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.
<br /> 2) In order to maintain the operating permit,the owner and operator shall comply with[lie H&S Code,Div.20,Chap.6.7 and 6.75;and CCR.Title 23,Chap,16 and 18,as well as any conditions
<br /> established by San Joaquin County.
<br /> 3) If the Tank Operators)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
<br /> the Tank Owner and tank Operator receive a Copy of the Permit.
<br /> 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Environmental Health Department(END)mid are considererd UST Permit Conditions. The approved
<br /> monitoring,response,and plot plans shall he maintained onsite with the permit.
<br /> 5) The PerrunWC shall comhply with the monitoring In referenced in this permit.
<br /> 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
<br /> provide documentation of such servicing to this office.
<br /> 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,An.5,and the approved Emergency Response Plan.
<br /> 8) Written records of all monitoring performed shall be maintained on-site by the operator and be available for inspection for a period of at least three years from the date the monitoring was
<br /> performed.
<br /> 9) The EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change.
<br /> 10) Upon any change in equipment,design or operation of the UST system(including change in lank contents or usage),the Permit to Operate wil I be subject to review,modification or
<br /> revocation.
<br /> 11) Construction,repair andlor removal permits are required from the EHD prior to any change,repair or removal of UST system equipment.
<br /> 12) This Perna to Operate shall not he considered permission to violate any laws,ordinances or statutes of any other Federal,Slate or Local agency.
<br /> 13) A"Conditional"Permit may be revoked if corrections specified on the inspection report are not completed by the dates) indicated.
<br /> PERMITS TO OPERATE may be SUSPENDED or REVOKED for cause.
<br /> PERMIT(s)Valid only for: SAFEWAY INC
<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> SAFEWAY FUEL CENTER#2707 Facility ID FA0002409
<br /> Regulated Facility: 6425 PACIFIC AVE
<br /> Account ID AR0004604
<br /> STOCKTON CA 95207 Issued 211912013
<br /> Billing Address: ATTN : MS #6516 TAX NASC
<br /> SAFEWAY FUEL CENTER #2707
<br /> PO BOX 29096
<br /> PHOENIX AZ 85038-9096
<br /> 7023rpt '
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