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SAN JOUIN COUNTY PUBLIC HEALTFRVICES <br /> P O Box 388W STOCKTON, CA 95201-0388 • PHOi. (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 /> OPERATING PERMIT FOR UNDERGROUND STORAGE TANK FACILITY <br /> Tank Tank Permit Annual Permit Fee Valid <br /> P/E Number Record ID Number capacity Contents Permit Status Fara To <br /> T)64 1 4 . 10,OW unleaded D Active erma 01101/9s 1 =I <br /> FERM I T CONDITIONS: � <br /> 1) The PERMIT TO OPERATE will become void if ANNUAL PERMIT Fees and SERVICE Fees are not paid and/or the tiST system(s) fails <br /> to remain ir, compliance with the PERMIT CONDITIONS. <br /> 2) The PERMIT TO OPERATE is granted to Pe TAW. OWNER who accepts responsibility for aerating and monitoring the t1ST system <br /> according to State underground storage tank laws and regulations as well as any conditions established by San Joaquin County. <br /> 3) The TAW, OPERATOR(S), if different from the tank owner, shall aerate and monitor the [IST system according to the WRITTEN <br /> OPERATING AGREEMENT required under Section 25293, Chapter 6.7, Division 20, California Health and Safety Code. <br /> 4) The TAW DAR shall notify the Environmental Health Division of any proposed change in alteration or ownership of the UST <br /> system <br /> 5) t1pon any change in equipment, design or operation of this facility, the PERMIT TO OPERATE will be reviewed by the <br /> Environmental Health Division. <br /> 5} A construction or removal permit is required fres the Environ ntal Plealth Division prior to any removal or <br /> chane of VST 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 tJST FACILITY issued to; TRACY COMMUNITY MEMORIAL HOSP <br /> 1420 N TRACY BL.V <br /> TRACY, CA 95:376 <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 D I SPLAYED CONSPICUOUSLY ON THE PREMISES <br /> RE91ATED FACILITY; TRACY COMMUNITY MEMORIAL. ;OSP Account ID-. 0002387 <br /> 1420 N TRACY BLVD Facility ID; 002562 <br /> TRACY, CA 9537€5 Permit Printed: 08/l 1/96 <br /> F . <br /> BILLING W.RE S: <br /> TRACY COMMUNITY MEMORIAL K2+:_P <br /> ATTN: TRACY COMMUNITY MEMORIAL WSP <br /> 1420 N TRACY BLVD <br /> TRACY, CA 9S376 <br /> �, , <br />