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:I v SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E.Weber Ave.,Third Floor•Stockton,CA 95202-2708 • Phone(209)468-3420 Donna Heran, R.&H.S., Director ENVIRONMENTAL HEALTH SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE Program Permit Permit Record ID Number Program Code and Description Valid PR0514053 PT0010248 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY 1/1/2004 To 12/31/2004 Hazardous Waste Generator Program: 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, Sec_25100-et seq,_and 22,Cof Regulations, __ _______________________________ - - - Title - - -alifornia-Code- Chap20 ---- ------------ ---------- ----- -------------------------------------- PR0232397 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/2004 To 12/31/2004 Underground Storage Tank Program: California Health and Safety Code,Div.20,Chap._6.7 and Title 23,California Code_of Regulations,-Chap.-16--------------------------------------------------------------- ------ ----- P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection 2362 1 390002323970239701 PT0006752 8,000 DIESEL Active, billable DOUBLE WALLED Continuous Interstitial Monitoring Underground Storage Tank Permit Conditions 1) The Permit to Operate will become void if Annual Permit Fees and Service Fees are not paid and/or the UST s}stern(s)fails to remain in compliance with these Permit Conditions. 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 tp established by San Joaquin Counn. 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 the Tank Owner and tank Ope.:or receive a copy of the permit. I 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Environmental Health Depar mnt(EHD)and are considererd UST Permit Conditions. The approved monitoring.response,and plot pans shall be maintained onsite with the permit. 5) The Permittee shall comply with the monitoring procedures referenced in this permit. 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually.or more frequently ifspecified by the equipment manufacturer,and provide documentation of such servicing to this office. 7) In the event of a spill,leak,or other unauthorized release,the Permitee shall comply with the requirements of Title 2-3 CCR,Chap.16,Art.5,and the approved Emergency Response Plan. 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 performed. 9) The EHD shall be notified of an,:change in ownership or operation of the UST system within 30 days of such change. 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 11) Ltd't gAiglbn,repair and/or remo•.al permits are required from the EHD prior to any change,repair or removal of GST system equipment. 12) The Pemtittee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 da%s of the date of the issuance of this permit. 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. 14) A"Conditional'Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: ST JOSEPHS REGIONAL HOUSING CO DBA: ST JOSEPHS REGINAL HOUSING Tank Owner: ST JOSEPHS MEDICAL CENTER CORP THIS FOWM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Regulated Facility: ST DOMINIC'S HOSPITAUMANTECA Facility ID FA0003978 1777 W YOSEMITE AVE Account ID AR0003603 MANTECA, CA 95336 Issued 4/1/2004 Billing Address: ST DOMINIC'S HOSPITAL/MANTECA P.O. BOX 213008 STOCKTON, CA 95213-9008 7023.rpt