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SAN JOAJUIN COUNTY PUBLIC HEALTHRVICES <br /> P O Box 388 ftocwmN, CA 95201-0388 • P-90209) 468-3420 <br /> ERNEST M. FUJIMOTO, M.D., M.P.H., ACTING HEALTH OFFICER <br /> DONNA RERAN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br />' ENVIRONMENTAL HEALTH <br /> STING PERMIT FOR UMERGMM STORAGE TAW FACILITY <br /> Tank Tank Permit Annual Permit Fee Valid <br /> PJE Number Record IO Weber C city Contents Permit Status From To <br /> 2380 003 TA10020a 005224 5,004 Unleaded 02 Condi Tonal Permit 01/01195 IF31/96 <br /> PERMIT GC+NDITIONS; <br /> 1) The PERMIT TO OPERATE will become void if PERMIT Fees and SERVICE Fees are not paid arid/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 TANK OWNER 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 establisher) by San Joaquin County. <br /> 3) The Tom?' OPERATOR(S), if different from the tank owner, shall operate and monitor the {QST system according to the WRITTEN <br /> OPERATING AGREEMENT required under Section 25233, Chapter 5.7, 'Division 20, California Health and Safety Code. <br /> 4) The TANS. NO shall notify the Environmental health Division of any proposed change in operation or cm*rship of the OST <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 /> 6) A construction or removal permit is required from the Environmental Health Division prior to any removal or <br /> charms of UST system equipment. <br /> 7) 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 /> S) A "Conditional Permit" may be revoked if corrections are not completed by the'date(s) specified on inspection. <br /> PERMIT TO OPERATE an LIST FACILITY issued to; DAMERON HOSPITAL <br /> 525_ W ACACIA_ <br /> STOC KTON, C A 9 S203 <br /> PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> THIS FORM M)ST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> REOl LATED FACILITY; DAMERON HOSPITAL Account ID; 0004S33 <br /> S2S W ACACIA Facility IU; 002864 <br /> STOCKTON, CA 55203 Permit Printed; 08i 11/9.5 <br /> BILLING ADDRESS; <br /> DAMERON HOSPITAL <br /> AT T N; DAMERON HOSPITAL <br /> 525 W ACACIA <br /> '=TOC KTON, CA 9620 <br />