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<br /> „r SAN JOAQUL ..OUNTY ENVIRONMENTAL HEAL __EPARTMENT
<br /> 600 E. Main St. • Stockton, CA 95202-3029 Phone(209)468-34201
<br /> Donna Heran,R.E.H.S.,Director s'
<br /> ENVIRONMENTAL HEALTH e ' i
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<br /> �- ;- ,• °' SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br /> PERMIT TO OPERATE
<br /> Program Permit s fr x + Permit
<br /> Record ID Number Program Code and Description �:t, _ s t,=x;' ' �'
<br /> Valid
<br /> PR0513649 PT0009844 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/2010 To 12/31/2010
<br /> Hazardous Waste Generator Program:
<br /> In order to maintain the permit to operate, Hazardous Waste Generators shall comply with California Health and Safety Code,Div.20,Chap.6.5,Art.2-13,
<br /> Sec.251 00etseq,and Title 22,-Galifornia_Code of Regulations,Chap._20-------------------------------------
<br /> PR 0231331
<br /> _______________PR0231331 2300-UNDERGROUND STORAGE TANK FACILITY /11/2010 To 12/31/2010
<br /> Underground Storage Tank Program:
<br /> California Health and Safety Code, Div.20,Chap.6.7 and Title 23,California Code of Regulations Cha 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 /> 2350 4 390002313310515887 PT0020176 20,000 DIESEL Active,billable DOUBLE WALLED Continuous Interstitial Monitoring
<br /> Underground Storage Tank Permit Conditions ',t r rr, , N, , �.�< < r �
<br /> N d) 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
<br /> v . ",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 /> established by San Joaquin County.
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<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 /> r 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.F
<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,
<br /> 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoringequipment annual/ ,or more frequently if specified b the equipment manufacturer,
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<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 wa$ j
<br /> performed. , _
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<br /> 9) The EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change.
<br /> •- 10) Upon any change in 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
<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. 'Y'.
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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. t
<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 ` ^ x
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<br /> 14) A"Conditional"Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated.
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<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
<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES `�
<br /> Regulated Facility: LODI MEMORIAL HOSPITAL x Facility ID FA0000513
<br /> � a< '� a,�� ` � rs ;4 xr s
<br /> r 975 S FAIRMONT AVEAi
<br /> � tI Account lD AR0000512
<br /> t LODI CA 94240 " l
<br /> - `#33` + °" i"r L ISSUEd 2/10/2010
<br /> Billing Address: ATTN GAYLE MOSES SAFETY/SECURITY MG:'
<br /> LODI MEMORIAL HOSPITAL ¥ �
<br /> 975 S FAIRMONT AVE < ' r
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<br /> LODI CA 95240
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