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<br /> g4`" SAN JOAQU OUNTY ENVIRONMENTAL HE
<br /> ALEPARTMENT
<br /> 600 E. Main St. • Stockton,CA 95202-3029 • Phone(209)468-3420 ¢
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<br /> Donna Heran, R.E.H.S., Director
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<br /> ENVIRONMENTAL HEALTH r,
<br /> s , SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY ,
<br /> s . ' PERMIT TO OPERATE ;
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<br /> ` Program Permit permit
<br /> Record ID Number Program Code and Description Valid
<br /> PR0513649 PT0009844 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/200$ To 1,2/31/2008
<br /> Hazardous Waste Generator Program: d,
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<br /> In order to maintain the permit to operate,Hazardous Waste'deneratois shall comply with California Health and'Safety Code,Div:20,Chap.6.5,Art.2-13,
<br /> Sec.25100 et seq;and Title 22,California Code of Regulations,Chap.20_
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<br /> ----------�. PR0231331 2300 UNDERGROUND STORAGE TANK FACILITY 1/1/200$ To 12/31/2008
<br /> 4' Underground Storage Tank Program: s _
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<br /> California Health and- a---y Code,_Div.20,Chap._6.7 and Title 23,_California Code of Regulations,Chap 16.
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<br /> P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection
<br /> 2362 3 390002313310133103 PT0005118 5,000 DIESEL Active billable DOUBLE WALLED Continuous Interstitial Monitoring
<br /> BOE ID#.;, 44-024651kz7wfti � a c x'�Y+ "r 0`
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<br /> Underground Storage Tank 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 systems)fails to reittain m compliance with these Permit Conditions.
<br /> 2) In order to maintain the operating permit,the owner and operator shall comply with 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
<br /> 1y established by San Joaquin County. »
<br /> 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'
<br /> f " the Tank Owner and tank Operator receive a copy of the permit.
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<br /> ;4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Environmental Health Department(EHD)and are considererd UST Permit Conditions. The approved
<br /> monitoring,response,and plot plans shall be maintained onsite with the permit.
<br /> 5) The Permittee shall comply with the monitoring procedures referenced in this permit k t a T may'( C'ror f „' 4 " 1,r) s l,g,i sgt
<br /> 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,ormore 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,Art.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 ai ' n*", q >
<br /> 10) Upon any change in equipment,design or operation of the UST system(including change in tank contents or usage),the Perriitt fn91 iX
<br /> peiate will be sujeet forevtew,modification'o
<br /> revocation.
<br /> 11) Construction,repair and/or removal permits are required from the EHD prior to any change,repair or removal of UST system equipment. s ^P
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<br /> 12) The Permittee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the date of the issuance of this permit r t
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<br /> 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, u/
<br /> 14) A"Conditional"Permit maybe revoked if corrections specified on the inspection report are not completed by the date(s) mdtcated.
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<br /> PERMITS TO OPERATE are NOT TRANSFERABLE
<br /> and maybe SUSPENDED or REVOKED for �p.
<br /> VI 4a PERMIT(s)Valid only LODI MEMORIAL HOSPITAL ;te Hs a f�
<br /> DBA: LODI MEMORIAL HOSPITAL -WEST
<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> 1 Regulated Facility: LODI MEMORIAL HOSPITAL '' ` ' �
<br /> �� r yt *� Facility ID FA0000513
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<br /> 975 S FAIRMONT AVE1�£a ��� "� `},� '' u N �`>x Account ID AR0000512
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<br /> Issued CA 94240 2/8
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<br /> Billing Address: ,.;r a r ;5 a'S S;,jY`�''"k +
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<br /> x x LODI MEMORIAL': HOSPITAL
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<br /> 975 S FAIRMONT AVE , t x
<br /> = LODI CA 95249 ` ?a � r' 'ori fz,s3
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