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SAN JOAQAS COUNTY PUBLIC HEALTH SEACES <br /> 304 E.WEBER AVE.,THIRD FLOOR - STOCKTON,CA 95202 - PHONE(209)468-3420 <br /> KAREN FURST,M.D., M.P.H., HEALTH OFFICER <br /> DONNA HERAN,R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> SAN JOAQUIN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY <br /> PERMIT TO OPERATE <br /> Program Permit Permit <br /> Record ID Number Program Code and Description Valid <br /> PR0231127 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/01 To 12/31/01 <br /> Underground Storage Tank Program: <br /> California Health and Safety Code Div.20,Chap_6.7 and Title 23 California Code of Regulations Chap. 16------------ --------- - - ----- ----- <br /> F7777 ___________ _________ _ _ _____ __P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status System Type Leak Detection <br /> 2360 8 390002311270508152 PT0009561 4,000 DIESEL Active DOUBLE WALLED INTERSTITAL MONITOR <br /> 2360 7 390002311270508151 PT0009560 8,000 PREMIUM UNLEADED Active DOUBLE WALLED INTERSTITAL MONITOR <br /> 2362 6 390002311270508150 PT0009559 12,000 REGULAR UNLEADED Active DOUBLE WALLED INTERSTITAL MONITOR <br /> Underground Storage Tank Permit Conditions <br /> 1) The Permit to Operate will become void if Annual Permit Fees and Service Fees arenot paid and/or the UST system(s)fails to remain in compliance with these Permit <br /> Conditions. <br /> 2) In orderlo maintain the operating permit,the permit holder shall comply with the H&S Code,Div.20,Chap.6.7 and 6.75;and OCR,Title 23,Chap.16 and 18,as wee as <br /> anyconditions established by San Joaquin County. <br /> 3) If the Tank Operators)is different from the Tank Owner,or if the Permit to Opet-ate is issued to a person other than the owner or operator of the tank,the Permittee shall <br /> ensurethat both the Tank Owner and tank Operator receive a copy of the permit. <br /> 4) Written Monitoring Procedures and an Emergency Response Plan must be approved bythe Environmental Health Division(PHS/EHD)and are considererd UST Permit <br /> Conditions. Copies of the Procedures and Emergency Response Plan must be attached to this permit or be available for review and/or inspection at the UST site. <br /> 5) The Permittee shall comply with the monitoring procedures referrenced in this permit. <br /> 6) The Permittee shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or more frequently if specified bythe equipment <br /> manu facturer,and provide documentation ofsuch servicing to this office. <br /> 7) In the event of a spill,leak,or other unauthorized release,the Permine shad comply with the requirements of Tile 23 CCR,Chap.16,Art.5,and the approved Emergency <br /> Response Plan. <br /> 8) Written records of all monitoring performed shad be maintained on-site bythe operatorand be available for inspection fora period of at bast three)ears from the date the <br /> monitoring was performed. <br /> 9) The PHS/EHD shall be notified of any change in ownership or operation of the UST system within 30 days of such change. <br /> 10) Upon any change in equipment,design or operation ofthe U ST system(including change in tank contents or usage),the Permit to Operate will be subject to review, <br /> modification or revocation. <br /> 1 l) Construction,repair and/or removal permits are required from the PHS/END prior to any change,repair or removal of UST system equipment. <br /> 12) The Permittee shall submit an annual report documenting compliance with the UST Permit Conditions within 30 days of the anniversary date of the issuance of this permit. <br /> 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. <br /> 14) A"Conditional"Permit may be revoked if corrections specified on the inspection report are not completed by the date(s) indicated. <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: PAKZAD, FRED <br /> Tank Owner: FRED PAKZAD <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: PARKWOODS BEACON* Facility ID FA0003611 <br /> 1612 W HAMMER LN Account ID AR0003189 <br /> STOCKTON. CA 95209 Issued 4/10/2001 <br /> Billing Address: ATTN : F PAKZAD, M HAMZEH,A HAMAN <br /> PARKWOODS BEACON* <br /> 1612 W HAMMER LN <br /> STOCKTON,CA 95209 <br /> 7023.rpt <br />