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SAN J(IPUIN COUNTY PUBLIC HEAL RVICES <br />P O Bog 388 • STOCWMN, CA 95201-0388 • PHo (209) 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 />PERMIT CONDITIONS: <br />1) The PERMIT TO OPERATE will become void if ANM PF-RI41T Fees and SERVICE Fees are not paid and/or the tr3T system(s) fails <br />to remain in compliance with tte PERMIT CROITIONS. <br />2) The PERMIT TO OPERATE is granted to the TAW 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 established by San Joaquin County. <br />3) Thee TW, OPERATOR(S), if different from the tank owner, shall operate and monitor the UST system according to the WRITTEN <br />OPERATING' AGREEMENT required wider Section 25293, Chapter 6.7, Division 20, California Health and Safety Code. <br />4) The TANK OWNER shall notify the Environmental Health Division of any Propsed change in operation or ownership of the UST <br />system. <br />5) Upon any change in equipment, design or operation of this facility, the PEERMIT 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 OPERATE shall not be considered permission to violate any existing laws, ordinances or statutes of other <br />federal, state or local agencies. <br />PERMIT TO OPERATE an UST FACILITY issued to; . C.ARDOZA, ED <br />183 N MAIN :ST <br />MANTE:C:A, CA 95336 <br />PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />THIS FORM MAST BE DISPLAYED COMWICUOUSLY ON THE PREMISES <br />RELATED FACILITY, ,.TIM'S EXXON/FOOD MART Account IN o000817 <br />1151 W !_OUI'SE Facility ID-. 000819 <br />MANTECA , CA 95336 Permit Printed; 08/11119S <br />:TIM'S, EXXON/FOOD MART <br />ATTN: .JIM THISSEN <br />1151 W LOU I SE. <br />MANTECA , CA 9S':D.: 5 <br />Tank <br />Tank <br />Permit <br />Annual Permit <br />Fee Valid <br />P/E <br />Pyr <br />Record ID <br />Number <br />Lapacity <br />Contents <br />Permit Status <br />From <br />To <br />2330 <br />061 <br />TA142901 <br />004262 <br />10,(W3 <br />aeaded <br />N1 cove emit <br />01101795 <br />12/31195 <br />2380 <br />02 <br />TA142%2 <br />04263 <br />10100 <br />Unleaded+ <br />01 Active Permit <br />01/01/95 <br />12131/95 <br />220 <br />tj <br />TA142903 <br />04N4 <br />10,0 <br />fay. 60rweln <br />01 Active Permit <br />01/01/95 <br />12/31/95 <br />PERMIT CONDITIONS: <br />1) The PERMIT TO OPERATE will become void if ANM PF-RI41T Fees and SERVICE Fees are not paid and/or the tr3T system(s) fails <br />to remain in compliance with tte PERMIT CROITIONS. <br />2) The PERMIT TO OPERATE is granted to the TAW 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 established by San Joaquin County. <br />3) Thee TW, OPERATOR(S), if different from the tank owner, shall operate and monitor the UST system according to the WRITTEN <br />OPERATING' AGREEMENT required wider Section 25293, Chapter 6.7, Division 20, California Health and Safety Code. <br />4) The TANK OWNER shall notify the Environmental Health Division of any Propsed change in operation or ownership of the UST <br />system. <br />5) Upon any change in equipment, design or operation of this facility, the PEERMIT 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 OPERATE shall not be considered permission to violate any existing laws, ordinances or statutes of other <br />federal, state or local agencies. <br />PERMIT TO OPERATE an UST FACILITY issued to; . C.ARDOZA, ED <br />183 N MAIN :ST <br />MANTE:C:A, CA 95336 <br />PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />THIS FORM MAST BE DISPLAYED COMWICUOUSLY ON THE PREMISES <br />RELATED FACILITY, ,.TIM'S EXXON/FOOD MART Account IN o000817 <br />1151 W !_OUI'SE Facility ID-. 000819 <br />MANTECA , CA 95336 Permit Printed; 08/11119S <br />:TIM'S, EXXON/FOOD MART <br />ATTN: .JIM THISSEN <br />1151 W LOU I SE. <br />MANTECA , CA 9S':D.: 5 <br />