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SAN JOAQW COUNTY PUBLIC HEALTH S�S <br />468 -VICE <br />P O Box 388 • TocxTox, CA 95201-0388 • PgolvE )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 />Tank Tank Permit Annual Permit Fee Valid <br />PIE Number Record IU limber Ci city Contents Permit Status From To <br />1 TA111101 00-5474 10, WO 1n eared 01 Active Permit --Ofl-01179,f��2/31/95 <br />2 7 002 TAIIII02 0*6475 101000 Unleaded 01 Active Permit 01/0119-S 12/3119S <br />PERMIT CONDITIONS: <br />1) The PERMIT TO OPERATE will become void if ANNUAL PERMIT Fees and SERVICE Fees are not paid and/car the tS,T system(s) fails <br />to remain in compliance with the PERMIT CONDITIONS. <br />2) The PERMIT TO LTERATE is granted to the TAMC OIAER 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 "an Joaquin County. <br />3) The TAW OPERATOR(S), if different from the tank croner, shall operate and monitor the UST system according to the WRITTEN <br />OPERATING AGREEMENT required under Section 25293, Chapter 6.7, Division 21), California Health and Safety Code. <br />4) The TANS OWNER shall notify the Environmental Health Division of any prmosed 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 />6) A construction or removal Permit is required from the Environmental Health Division prior to any removal or <br />change of UST system equipment. <br />7) This PERMIT TO GATE shall not to considered permission to violate any existing laws, ordinances or statutes of other <br />federal, state or local agencies. <br />41 +1 <br />PERMIT TO OPERATE an UST FACILITY issued to; Q f I K STOP MARKETS <br />PO BOX S745 <br />FREMONT , CA 94-S-37 <br />PERMITS TO OPERATE and ANNUAL. PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />THIS FORM MUST BE DISPLAYED COMSP I CUt1 JSLY ON THE PREMISES <br />REGULATED FACILITY: <br />BILLING ADDRESSS: <br />QUIK STOP MARKETS #39 <br />228S E FREMONT <br />STOCKTON , CA 95200 <br />QV I K STOP MARKETS INC: <br />PO BOX S 4S <br /><.a FREMONT , CA 945.37 <br />Account ID: 0001658 <br />Facility ID- 0"!016S'3 <br />Permit Printed: 081111' 5 <br />t <br />