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SAN JOA-OUIN COUNTY PUBLIC HEALTHk,RVICES <br /> 304 E.WEBER AvE.,THIRD FLOOR • STOCKTON,CA 95202 • PHONE(209) 468-3420 <br /> KAREN FORST,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 /> Permit <br /> Promm Permit Program Code andDescription Valid <br /> Record to Number 111101 To 12/31101 <br /> PRO513620 PT0009815 2220-SMALL QUANTITY HAZARDOUS WASTE GENERATOR FACILITY <br /> Hazardous Waste Generator Program: <br /> California Health and S e Div_20,Chap_6.5,-Art_2-13 Sec.25100 et seq:and TiUe 22 Califomia Code of Regulations,C_hap. 111 ____-_-.-__- <br /> PR0506972 PT00091 DOUS WASTE CESW FACILITY 1/1101 To 12131101 <br /> Tiered Permit On Site HmllnoRffste Treatment Program: <br /> California Health and Safety Code Div_20_Chap_6.5,-Art_9,and TiOe 22 Califomia Code of Regulations,Chap_20---------------i <br /> _____________ ___ __. <br /> PR0231002 2300-UNDERGROUND STORAGE TANK FACILITY 111/01 To 12/31/01 <br /> Underaround Storage Tank Prooram• <br /> California Health and Safety Code Div_20_Chap_6.7 and TiOe 23 Califomia Code of Regula0ons Chap_76______ _________________________ <br /> P/E Tank# Tank Record ID Permit# Capacity Contents Permit Status <br /> 2362 3390002310020100203 PT0005224 6,000 UNLEADED Conditional <br /> OOE 1[k1:=..da:024M182;u�-,.��j�j <br /> Underground Storage Tank Permit Conditions <br /> 1) The Permit to Operate will become void if Annual Pur it Fees and Service Fees are not paid and/or the UST system(s)fails to remain in compliance withthese Permit <br /> Conditions. <br /> 2) In order b maintain the operator g permit,the permit holder shall comply with the H&S Code,Div.20,Chap.6.7 and 6.75;and CCR,Title 23,Chap.16 and I8,as web as <br /> any conditions established by San Joaquin County. <br /> 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 Permitter shall <br /> ensure that 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 by the Environmental Health Division(PHS/EHD)and are considered 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 Par itme shall perform testing and preventive maintenance on all leak detection monitoring equipment annually,or mom frequently if specified bythe equipment <br /> manufacturer,and provide documentation of such servicing to this office <br /> 7) In the event of a spill leak or other unauthorized release,the Permitee sha8 munplywith the requirements of Title 23 CCR,Chap. 16,Art.5,andthe approved Emergency <br /> Response Plan. <br /> 8) Written records of all monitoring performed shall be maintained on-site by the operatorand be available for inspection fora period of at least three years 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 of the UST system(m cluding change in tank contents or usage),the Permit to Operate will be subject In review, <br /> modification or¢vocation. <br /> l 1) Construction,repair and/or removal permits are required from the PHS/EHD 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 ofthe issuance ofthis 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: DAMERON HOSPITAL <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: DAMERON HOSPITAL Facility ID FA0002864 <br /> 525 W ACACIA ST Account ID AR0004533 <br /> STOCKTON. CA 95203 Issued 3129/2001 <br /> Billing Address: ATTN : ACCTS PAYABLE-MARGIE <br /> DAMERON HOSPITAL <br /> 525 W ACACIA <br /> STOCKTON, CA 95203 <br /> 7o23.rpt <br />