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SAN JOAQUINN COUNTY ENVIRONMENTAL HEALTH UEPARTMENT <br /> 304 E.Weber Ave.,Third Floor•Stodcton,CA 95202-2708•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 Program Code and Description <br /> Valid <br /> PR0513649 PT0009844 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FAOLITY 1/1/2007 To 12/31/2007 <br /> Hazardous Waste Generator Program: a <br /> In order to maintain the permit to operate,Hazardous Waste Generators shall comply with California Health and Safety Code,Dict.20,Chap.6.5,Art.2-13, *4 � <br /> Sec.25100 et se ,and Title 22,Ca_fortna Code of Regulations,Chap.20_ ' <br /> -------------------- ------ --- -- ---- <br /> PR0231331 2300 NDERGROUND STORAGE TANK FACILITY"- 1/1/2007 To 12/31/2007 <br /> - <br /> Underground Storage Tank Pro ram: <br /> California Health and Safety Code; lv 20,Chap. and Title 23;California Code of Regulations,Chap, 16 <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 /> Underground Storage Tank Permit Conditions x <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)faits tO remaigtn cotnpliance,( tM these Permit Conditions <br /> 2) . Li.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 /> 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 /> 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(EHD)and are considererd IJSTlt`ermit Conditions. The approved <br /> monitoring,response,and plot plans shall be maintained onsite with the permit. <br /> S), The Permittee shall comply with the monitoring procedures referenced in this permit. � t <br /> d) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently tf speoi&ed by the equipment manufacturer,and <br /> �lrovide documentation of such servicing to this office. rri <br /> .1n the event of a spill,leak,or other unauthorized release,the Permitee shall comply with the requirements of Title 23 CCR Chap.]6 Ari 5;aiid'the aWroved Emergency Response Plan. r <br /> 9) -Written records of all monitoring performed shall be maintained on-site by the operator and be available for inspection fora petlod ofiit ltasi.thra'years from the date the monitoring was z <br /> performed. g t <br /> he EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change: ¢ 14 <br /> 10) Upon any change to equipment,design or operation of the UST system(including change in tank contents or usage),the Permit to Operate will be subject to review,modification or r <br /> revocation. .a'•..,t <br /> 71 Construction,repair and/or removal Permits are required from the EHD prior to any charge,repair or removal of UST system equipment. <br /> t 3 } <br /> (2) The Permittee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the date of the issnanpe oftbis pennit. ° <br /> 1. This Permit to Operate shall not be considered permission to violate an laws,ordinances or statutes of an other Federal,State or Local a e <br /> Pe Pe Y Y g 4cY. <br /> 14) 'A"Conditional"Permit maybe revoked if corrections specified on the inspection report are not completed by the date(s) indicated. <br /> x <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause <br /> PERMIT(s)Valid only for: LODI MEMORIAL HOSPITAL - <br /> DBA: LODI MEMORIAL HOSPITAL -WEST r { <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> h' <br /> Regulated Facility: LODI MEMORIAL HOSPITAL FactlltylD;FA0000513 <br /> 975 S FAIRMONT AVE AccountiD AR0000512 <br /> LODI CA 94240 Issued 2/13/2007 , <br /> Billing Address: <br /> LODI MEMORIAL HOSPITAL, <br /> } tp <br /> 975 S FAIRMONT AVE .,. i <br /> f;ODI CA 95240 <br /> W. <br /> t <br />