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SAN JO N COUNTY PUBLIC HEALTH HONE ICES 304 E. WEBER AVE., IHRD FLOOR • STOCKTON,CA 95202 • P (209) 468-3420 KAREN FURST, M.D., M.P.H., HEALTH OFFICER DONNA HERRN, R.E,H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION ENVIRONMENTAL HEALTH SAN JOAQUiN COUNTY CERTIFIED UNIFIED PROGRAM AGENCY PERMIT TO OPERATE rogram Permit Permit Record I Number Program Code and Description Valid PR023141 2300-UNDERGROUND STORAGE TANK FACILITY 1/1/00 To 12/31/00 Underground Storage Tank Program: California Health and Safety Code Div.20,Chap.6.7 and Title 23 California Code of Regulations Chap. 16. anIZ 17 1 anK Kecoraerne apace y on ens Pernut Status 2360 3 390002314130141303 PIOU04433 10,000 REGULAR UNLEADED Active 2360 2 390002314130141302 PT0004432 10,000 MIDGRADE UNLEADED Active 2360 1 390002314130141301 PT0004431 8,000 REGULAR UNLEADED Active 130E 1D# '44-018763 Underground Storage Tank Permit Conditions 1) The Permit to Operate will become void if Annual Permit Dees and Service Fees are not paid and/or the UST system(s)fails to remain in compliance with these Permit Conditions. 2) In order to maintain the operatingpermit,the pennit holder 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 established by San Joaquin County. 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 Operator receive a copy of the permit. 4) Written Monitoring Procedures and an Emergency Response Plan must be approved by the Environmental Health Division(PHS/EHD)and are considererd UST Permit Conditions. Copies of the Procedures and Emergency Response Plan must be attached to this permit or be available for review and/or inspection 5) itlr$ermittseetshall comply with the monitoring procedures referrenced in this permit. 6) The Permittee shall perform testin&and preventive maintenance on all leak detection monitoring equipment annually,or more frequently if specified 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 Pemtitee shall comply with the requirements of Title 23 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 PHS/EHD shall be notified of any change in ownership or operation of the/1ST 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 Penn it to Operate will be subject to review,modification or revocation. 11) Construction,repair and/or removal permits are required from the PHS/EI-ID prior to any change,repair or removal of UST system equipment. 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. 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 datc(s) indicated. PERMITS TO OPERATE are NOT TRANSFERABLE and may be SUSPENDED or REVOKED for cause. PERMIT(s)Valid only for: QUIK STOP MARKETS INC DBA: QUIK STOP 77115 FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES Regulated Facility: QUIK STOP MARKETS 138 Facility ID FA0003122 1153 LINCOLN BLVD Account ID AR0002686 TRACY, CA 95376 Issued 10/9/2000 Billing Address: ATTN : QUIK STOP MARKETS INC QUIK STOP MARKETS 138 4567 ENTERPRISE ST FREMONT, CA 94538 7023.rpt