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SAN JOAQUIN COUNTY <br />'r ENVIRONMENTAL HEALTH DEPARTMENT <br />304 Ea Weber Avenue, 3rd Floor, Stockton, CA 95202- 708 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.or ehd <br />UNDERGROUND CTnRAt^_RTANLe- r7TcmX. <br />Facilih� name: <br />- ---- - -t. �a2 sa�vvn �tvi 11vJr> l ilU1V 1tPPORT <br />Myo SvNQ <br />Designated Operator: <br />LS6 Data <br />Inspection Date: <br />C.A�L M05W <br />1-6-ofo <br />Facility <br />address: <br />239 S. Sroc�rorl S( USTtI y , 5 <br />ry <br />Facility Contact:Title: <br />- Product D5L - Q7 SL <br />Phone: <br />Monitoring Panel: <br />Piping system: - " <br />N 5 -Il <br />'rJ6� <br />Overfill prevention: <br />❑ Pressurized <br />Inspection type:echanical <br />uction ❑ Gravity ❑ Audible/visual <br />Routine Mom orm <br />solations: <br />Certification ❑ Installation ❑ Other: ❑ MI-RDetect ❑ M2-RPrev <br /># Code Section <br />VIOLATIONS) HSC=Califomia Health & Safety <br />❑ M-3 Bath <br />Code; CCR=Califomia Code of Regulations <br />V R <br />V=Violation; RV=Re eat Violation <br />V <br />I <br />HSC 25284 <br />Permit too este <br />2 <br />CCR 2637 <br />Second containment test perforrrted <br />3 <br />CCR 2711 b & c <br />Current Unified Program Consolidated <br />Forms on file with EHD Facility and tank form <br />4 <br />HSC 25292.2 <br />Certification of financial responsibilitZ <br />5 <br />CCR 2632 c 2 D <br />and CFO letter <br />Monitorin & response is <br />plan current and filed with the local a enc <br />6 <br />CCR 2712 i <br />monitorin & resl3onse is onsite <br />7 <br />CCR 2712 b <br />plan <br />Maintenance & monitoring records <br />8 <br />CCR 2643 d. <br />Dail monitorin of suction i in <br />MI <br />re -Jana , 1, 1984 <br />9 <br />HSC 25292.1 <br />UST s stem is o crated to <br />10 <br />CCR 2632 c 2 <br />Prevent unauthorized release <br />UST monitorin system is resent <br />11 <br />CCR 2630 d <br />UST s stem monitorin a ui ment is located detect <br />MI <br />12 <br />HSC 25291 <br />2roperly to a leak <br />UST s stem monitorin a ui ent is o2 erational <br />MI <br />13 <br />CCR 2636 1 <br />Continuous monitoring s stem for under round piping &UDC is resent <br />14 <br />CCR 263 1a <br />Prim containment is product ti ht <br />Ml <br />15 <br />HSC 2529] (a 2) <br />Secondar containment for UST is ti ht <br />16 <br />CCR 2636 c (1) <br />All releases in sewn ­,i in flow to a collection sum <br />17 <br />HSC 25291 <br />Line leak detectors are installed <br />18 <br />CCR 2635 6 1 <br />S ill container <br />Ml <br />19 <br />CCR 2635 b 2 <br />Overfill revention s stem <br />M2 <br />20 <br />CCR 2636 a <br />Conventional .ave continuous monitorin & 2° <br />M2 <br />21 <br />HSC 25291 (e) <br />containment <br />Water in 20 containment analyzed & properly dis osed of <br />22 <br />CCR 2650 <br />Recordin re orting of unauthorized releases <br />23 <br />24 <br />CCR 2715 <br />Desi ated O erator: a Statement from UST owner; (r. -P) Monthl ins ection; f) Em to ee [raisin <br />Ml <br />CCR 2638 a <br />Annual monitorin certification <br />25 <br />CCR 2638 a) <br />Annual line leak detector test <br />26 <br />HSC 25284.2 <br />Annual s ill containment testis <br />MI <br />27 <br />CCR 2636 4 <br />Annual line ti hmess test <br />28 <br />CCR 2661M1 <br />( <br />Re air for tanW i in has had tightness test <br />29 <br />CCR 2643 (e <br />Biennial ti hmess teL of city piping re -Janus 1, 1984 <br />M2 <br />30 <br />CCR 2643 d <br />Triennial line test for conventional suction i in re -Jana 1, 1984 <br />31 <br />HSC 25292.5 <br />Double wall s stem located within 1000' of ublic well-ELD <br />MI <br />32 <br />CCR 2661 <br />Permit to r air UST s stem <br />33 <br />HSC 25286 a <br />Permit to alter monitorin s stem <br />34 <br />HSC 25298 <br />Permit to temp -mil close UST s stem <br />35 <br />HSC 25298 c <br />Permit to close UST s stem <br />36 <br />HSC 25299 a 9 <br />T)i..I%I,,ng leak detect on devices <br />37 <br />HSC 25298 a <br />Illegal abandonment of UST s stem <br />35 <br />Other. <br />EHD <br />INSPECTOR: <br />PHONE: <br />W-4 <br />UIC <br />y 6 g -34f q Septic system <br />REC <br />ED BY: <br />TITLE: -i Serves>20 people/day <br />Receives other than <br />sanitary waste <br />Other disoosal methods- <br />- Dry wellc/Prenrh <br />EHD 23-02-002 <br />