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3 EOI RO N M ENTAL H EAA-i POST ON PREMISE <br /> ISSUED: EXPIRES: <br /> PERMIT N0. 001.31 1 ,of 1 <br /> August 26, 1563 December :31, 1539 SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> Permit issued to: 1601 E. HAZELTON AVE. • PHONE 466-6781 <br /> P.O. BOX 2009 9 STOCKTON, CA 95201 <br /> LORI MEMORIAL HOSPITAL <br /> 975 `.3. FAIRMONT <br /> LORI' t.A 95240 OPERATING PERMIT FOR UNDERGROUND <br /> Status; 01 - STORAGE TANK FACILITY <br /> ;TIM BLAIN TANK OWNER LODI MEMORIAL HOSPITAL <br /> Fi i S}X : 434 975 S. F 4I RMONT <br /> LC;G I CA. 9,6241 LitD i CA 9SI,40 <br /> NUMBER OF TANKS 03 <br /> Tank- Description Product Capacity LDM Status <br /> 0001 TANTS Motor Vehicle Fuel 1,000 7 01 <br /> 0002 TANKS Motor Vehicle Fuel 15,000 08 <br /> 000:3 TANKS Motor Vehicle Fuel S,000 26 01 <br /> CONDITIONS <br /> 1. This permit expires in five (5) years and is renewable thereafter. Inspection fee will be billed annually. <br /> 2. This permit is granted to the tank owner who accepts responsibility for operating and monitoring the tank <br /> system according to state underground storage tank laws and regulations and conditions set by the county. <br /> 3. Tank operators, if different than the owner, shall operate and monitor the tank system according to the <br /> written operating agreement required under Section 25293, Chapter 6.7, Division 20, California Health and <br /> Safety Code. <br /> 4. Tank owner shall notify the Environmental Health Division of any proposed change in operator or ownership <br /> of tank system. <br /> 5. Upon a significant change in design or operation of this facility, permit will be reviewed by the <br /> Environmental Health Division. <br /> 6. This permit cannot be considered as permission to violate existing laws,ordinances, regulations or statutes <br /> of other governmental agencies. <br /> jogi Khanna, M.D. , MRH Ronald Valit-soti , R.S. <br /> District Health Officer Director of Environmental Health <br /> THIS PERMIT MAY BE SUSPENDED REVOKED FOR CAUSE • <br />