|
r0
<br /> }n
<br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 13 � a
<br /> 600 E. Main St. • Stockton, CA 95202-3029 • Phone(209)468-3420
<br /> h °S of%"•s ,,�.'✓+":`�' S4' x '� �.,
<br /> 1`�`� � rr Donna Heran,R.E.H.S.,Director
<br /> ENVIRONMENTAL HEALTH, �� �
<br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY
<br /> PERMIT TO OPERATE
<br /> v Program Permit
<br /> Permit
<br /> Record ID Number Program Code and Description Valid
<br /> ., PR0513649 PT0009844 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1!1/2009 To 12/31/2009
<br /> I ..
<br /> ury? 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.25100 et seq,and Title 22,California Code of Regulations,Chap.20_
<br /> - -------- -------- ----------- ------- -------- ----------
<br /> PR0231334 2300.UNDERGROUND STORAGE TANK FACILITY 1/1/2009 To 12/31/2009
<br /> Underground Storage Tank Program:
<br /> California health and Safety Code,Div.20,Chap.6.7 and Title 23,California Code of Reulations,Chap: 16.
<br /> - ----- - ------ ----- ------------------------- --- -- ----- ----
<br /> ------ - --- - ---------- - ---
<br /> A P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection
<br /> 2362 >' 2313310133103 PT0005118 5,000 DIESEL Active,billable DOUBLE WALLED Continuous Interstitial Monitoring
<br /> r
<br /> "yt '9
<br /> Un oi' ¢ ank Permit Conditions A yr
<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 to remain in compliance with thesePermifConditions.
<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 /> established by San Joaquin County.
<br /> 1i 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 UST Permit Conditions. The approved
<br /> monitoring,response;and plot plans shall be maintained onsite with the permit.
<br /> 5) The Pennittee shall comply with the monitoring procedures referenced in this permit.
<br /> 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more 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 /> t ate,
<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.
<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 a
<br /> revocation.
<br /> a
<br /> 11) Construction,repair and/or removal permits are required from the EHD prior to any change,repair or removal of UST system equipment. t
<br /> g 12) The Pemxittee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the date of the issuance ofthis
<br /> permit. >s
<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: '
<br /> X
<br /> �i
<br /> R� ' 14) A"Conditional"Permit may be revoked if corrections specified on the inspection report are not completed by the dates) indicated. s v
<br /> Ise 1
<br /> k���,.tx tk;• '�r,�*k .�i �t ..:`�� =4�{,-. �..r M�" k ��ti�kx�#! ,i����.,s.�, ,;.`..�a ri t �a :�.gNt��s'�^rx?;r�+F r a aai'" f s U?°�,{ sr�y��� ra,.
<br /> r„+ s �: -fit' u,BR, t t✓ �... x d� �'�` tw z '+�`:, �i x:
<br /> t% �� y � ,ar �� ��x � �"✓N.u'. %� M��'y"v{r�, 'a °K`:,C4 b � .,Y'`�, �,��N �`
<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 Facility 1D
<br /> FA0000513
<br /> 975 S FAIRMONT AVE Account ID AR0000512,,,
<br /> LODI CA 94240 d
<br /> •' Issued
<br /> 2/4/2009
<br /> .... Billing Address: r ' n aY+si :,, t �"„,r � t61 T ..fir '.} ✓f k 5'Cf'�y, s ' + �'°s s
<br /> ,:, •s.nprt....; � `a 1 { i'�'. `. rF4 r t4r'' :'+�* :%r
<br /> ` h
<br /> ,} ,4 LODI MEMORIAL HOSPITAI;
<br /> v
<br /> sgs ': 975 S FAIRMONT AVE
<br /> r x� LODI CA 95240 w yq
<br /> �"!✓�� Sr+,�ds+}�a�'.^` a4'rf.a`}°y°� �"a��,�' { �'�i,r'u�'.'".4,�,�•`•:., s ,„,.�h.<i � v �+� �bt� ."r .�, "� � �.-J�
<br /> n ,s '"�•m x� :� ��,'si �2,�tP sy `"`�-d�,t�e'+� - �,'.�, g , 'a {;` cr::lr,� 4 r, �rsr j�.,�.ate a r s F���'✓ '�
<br /> �'�"�,� 5 ` rX`�' "_ yv ' i.,+4'x"7"1„yr.��,rt�r�N]�t, �,,,�, � �' wrw%' •; $,'�"�a*��"� rP ^., ` S k�� >: ='�
<br /> 2'
<br /> F-c�3 c �s r �p'�.d '�'�`" t5 ✓fi;:• fi"4 .. s{,�' t.� � �r r�e;3*� °K �.-r{`i?'� aid. ,� _e�.y, ry.� ,� ar za ��aa ��`
<br /> �' ��F�.�� . � - •v.* �,$x�r,.,:::.,�„�s..,�.L..isea�+.�' .w9aa'� �w,,..�; �"�:�r-.. 't�t , , _,i,,..r..,. ,... - . ., .�,... z. .a ._._..s.<;
<br />
|