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' SAN JOIN COUNTY PUBLIC HEALTHVICES <br /> 304 E.WEBER AVE.,— IRD FLOOR • STOCKTON,CA 95202 PAQNE(209)468-3420 <br /> KAREN FURST, M.D., M.P.H., HEALTH OFFICER <br /> DONNA RERAN,R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> 1. TING PERMIT FOR I ERGM1.1 STORAGE TAS. FACILITY <br /> Tank Tari Permit Annual Permit Fee Valid <br /> P/E Number Record ID Number Capacity Contents Permit Status From To <br /> 2380 003 TAI-33103 005118 51000 Diesel 01 Active Permit 01/0168 111/31/98 <br /> PERMIT CONDITIONS: <br /> 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 <br /> to remain in compliance with the PERMIT CONDITIONS. <br /> 2) The PERMIT TO OPERATE is granted kn the TAN` OWNER who accepts responsibility for operating and monitorir►g the OST system <br /> according to State underground storage tank laws and regulations as well as any conditions established by Sari Joaquin County. <br /> 3) The TANK OPERATOR(S), if different from the tank owner, shall operate and monitor the U'iT system according to the WRITTEN <br /> OPERATING AGREEMENT rewired under Section 2,293, Chapter 6.7, Division 20, California Health: and Safety Code. <br /> A) The TANK OWNER shall notify the Environmental Health Division of any proposed change in operation or ownership of the UST <br /> system. <br /> 5) Upon any charms in equipment, design or operation of this facility, the PERMIT TO OPERATE will be reviewed by the <br /> Environmental Health Division. <br /> ,) 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 /> PERMIT TO OPERATE an UST FACILITY issued to: LOO I MEMORIAL HOSP I TAL <br /> 975 S FA I RM►sNT <br /> LODI I , €:A 94224.t I <br /> PERMITS TO OPERATE and ANNUAL PERMIT FEE: PAYMENT`_-; r e NOT TRANSFERABLE <br /> and may be SUSPENDED +-r' REVOKED f c-r cause . <br /> THIS FORM MUST BE DISPLAYED C04SPICWJSLY ON THE PREMISES <br /> REGULATED FACILITY: LOD I MEMORIAL HOSPITAL TAL Account ID: O(K)0512 <br /> 977 S FAIRMONT Facility ID: 00513 <br /> LOLS I , CA 94240 Permit Printed: 03/02/99- <br /> BILLING <br /> 3/02/99BILLING ADDRESS: LOD I MEMORIAL HOSPITAL <br /> P"TTS•!' FACILITY MANAGEMENT <br /> r.,-. ?A <br />