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Tlk SAN A 4UIN COUNTY PUBLIC HEALTH RVICES <br /> 304 E.WEBER AVE., HIRD FLOOR • STOCKTON,CA 95202 NE(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 /> ��TI IT FOR LNDERMMMD STORAGE T FACILITY <br /> LITY <br /> Tank Tank Permit Annual Permit Fee Valid <br /> P/E Number Record ID Number Capacity Contents Permit Status Frond To <br /> 2350 003 TA100203 005224 6,000 Unleaded 02 Conditional Permit. 011011.8 12/31193 <br /> PERMIT CONDITIONS: <br /> 1) The PERMIT TO OPERATE will become void if ANNUAL PERMIT Fees and 'SERVICE Fees are riot paid and/or the UST system(s) fails <br /> to remain in compliance with the PERMIT CONDITIONS. <br /> 2) The PERMIT TO OPERATE is granted to the TANX OWNER who accepts responsibility for operating and monitoring the UST system <br /> according to State undergrcuid 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 25. 33, Chapter 6.7, Division 2-0, California Health and Safety Code. <br /> 4) The TANG( OWNER shall notify the Environmental Health Division of any proposed change in operation or ownership of the UST . <br /> system. <br /> S) 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 /> 6) A construction or removal permit is required from the Environmental Health Division prior to any removal or <br /> change of kJQT system equipment. <br /> 7) This PERMIT TO OPERATE shall riot be considered permission to violate any existing laws, ordinances or statutes of other <br /> federal, state or local agencies. <br /> 8) A "Conditional Permit" may be revoked if corrections are not completed by the date(s) specified on inspection. <br /> PERMIT TO OPERATE an 4/ST FACILITY issued to: DAMERON HOSPITAL <br /> SSS W ACACIA <br /> PERMITS TO OPERATE and ANNUAL PERMIT FEC PAYMENT':: a 1-e NOT TRAN'ZFERABLE <br /> aria rfray L,e SUSPENDED c-r REVOKED f c r• c a.tise . <br /> THIS FURM MUSI , 1DI C9NSP1CtUUGLY ON TIHE PREMISES <br /> RERLATED FACILITY, DAME:RCIN HOSPITAL Account ID: K10493 <br /> SATS W ACACIA Facility ID: 002564 <br /> STOCKTON, CA 9S203 Permit Printed: 03/02/93 <br /> BILLING ADDRESS: DAMERCIN HOSPITAL <br /> ATTN : ACCTS PAYABLE—MARDIE <br /> S 2`5 W ACACIA <br /> STOCKTON, CA 95203 <br />