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SAN JOAzJIN 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 Permit Program a Permit Program Code and Description Valid Record ID ±011111111111110 PR cord ID D5qffftpUNDERGROUND STORAGE TANK FACILITY 1/1101 To 12/31/01 Underground Storage Tank Program: Califomia Health and Safety Code Div_20,Chap_6.7 and Title 23_California Code of Regulations Chap._16_ _ _ __ ___ _ _ _ _ ____ __ ___ _ _ _ _ _ _ _ _ _ _ _ . P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection 2360 11 390002310550515430 P71 T0010873 10,000 PREMIUM UNLEADED Active SINGLE WALLED INVENTORY REC/MANUAL 00 REGULAR UNLEADED Active SINGLE WALLED INVENTORY REC/MANUAL 2362 10 390002310550515429 PT0010872 20,0 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 operating permit,the permit holder shall complywith the H&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) 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. 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Environmental Health Division(PHS/EHD)and are considererd UST Permit Conditions. Copies of the Procedures and Emergency Response Plan must be attached to this permit or be available for review and/or inspection at the UST site. 5) The Permittee 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 bythe equipment manufacturer,and provide documentation ofsuch 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. 8) Written records of all monitoring performed shad be maintained on-site by the operatorand be available for inspection fora period of at least three years from the date the monitoring was performed. 9) The PHS/EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change. 10) Upon any change in equipment,design or operation ofthe 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. 12) The Permittee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the anniversary date ofthe issuance ofthis 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 and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: GILL,JODHA THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Facility ID FA0002321 Regulated Facility: UNITED GAS''440 WCJ_AART,4-RP Account ID AR0002335 ` Y Issued 3/29/2001 STOCKTON. CA 95206 Billing Address: ATTN : JODHA GILL UNITED GAS" PO BOX 1136 TRACY, CA 95378 7023.rpt