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SAN JO, IN COUNTY PUBLIC HEALTH VICES <br /> 304 E.WEBER AVE., n FLOOR • STOCKTON,CA 95202 • P (209) 468-3420 <br /> KAREN FURST, M.D., M.P.H., HEALTH OFFICER <br /> DONNA HERRN,R.E.H.S.,DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> L-ffMTINGIT FOR UNDERMOLMST-ESTCRAGE TAW FACILITY <br /> Tank: Tank Permit Annual Permit Fee Vaud <br /> P/E Number Record 10 Number Capacity Contents Permit Status From To <br /> 23(t 005 TA507190 01Y9250 IS,0) Prem Unleaded 01 Active Permit 03/111/38 12/3113Os <br /> 2350 005 TA507191 00'4255 20,(0 Prem Unleaded 01 Active Permit 03,'11135 12/311% <br /> PERMIT CONDITIONS: <br /> I) The PERMIT TO OPERATE will become void if ANNUAL PERMIT Fees and SERVICE Fees are not paid and/or the t°ST system(s) fails <br /> to remain in compliance with the PERMIT G)NDITIONS. <br /> 2) The PERMIT TO OPERATE is granted to the TAW OAR who accepts responsibility for operating and monitoring the UST system <br /> according to State underground storage tank laws and regulations as well as any conditions established by San Joaquin County. <br /> 3) The TANK OPERATOR(S), if different from the tank owner, shall operate and monitor the UST system according to the WRITTEN <br /> OPERATING AGREEMENT required under Section 25233, Chapter 5.7, Division 20, California Health and Safety Code. <br /> 41 Tt-k-- TANK OWNER shall notify the Environmental Health Division of any proposed change in operation or ownership of the UST <br /> system. <br /> 5) Upon any change in equipment, design or operation, of this facility, the PERMIT TO OPERATE will be reviewed by the <br /> Environmental Health Division. <br /> o) A construction or removal permit is required from the Environmental Health Division prior to arty removal or <br /> change of UST system equipment. <br /> ') This PERMIT TO OPERATE shall not be considered permission to violate any existing laws, ordinances or statutes of other <br /> federal, state or local agencies. <br /> PERMIT TO OPERATE an UST FACILITY issued to= CHEVRON USA INC: <br /> PO BOX 6°0014 <br /> SAN RAMON,, C:A 94-583 <br /> P=ERMITS TO OPERATE aiid ANNUAL PERMIT P=EE PAYMENTS are NOT TRANSFERABLE <br /> artd €(tay be -SUSPENDED c r REVOKED f or cause. <br /> THIS FORM MUST BE; DISPLAYED C04SPICtOUSLY ON T'1: PREMISES <br /> REGULATED FACILITY: CHEVRON STATION #1 S80 Account. ID- 0003236 7 <br /> :34.4 E WATERLOO RCS Facility ID; 003717 <br /> 'S=TOC:KTON . C:A, 9527,05 Permit Printed; 03/14/98 <br /> 3ILLING AODRES � CHEVRON 'S TAT I ON-3=, I NC.: (CS I i <br /> ATTN: CHEVRON 'STATIONS INC: <br /> G,C.I:€ AMERICAN AVE STE 200 <br /> KING CIF FRta'=SIA, PA 1940I_° <br />