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PUBLIC HEALTH SERVICES SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DIVISION <br />304 E. Weber rive., Third Floor, Stockton, CA 95202 <br />(209) 468-3420 <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />;, �5 <br />Facility Name . ,w <br />Facility Address <br />ontact <br />Facilty Contact Title �` u tlt, Phone No. A <br />Program ID# 5�/ Number of UST(s)_( <br />UST# / Product�Q <br />AJ <br />Overfill Prevention: Audible ori Visual N �Mechanical— <br />O )V I .� <br />Piping system: Gravity-----1'ressure _ <br />Monitoring system fU U N L" <br />Automatic pump shutdown satisfies CCR2636 (g): Yes No__K_ <br />VIOLATIONS) <br />The above facility is not in compliance with the following section(s) of Health & Safety Code <br />(HSC) and/or California Code of Regulations (CCR): <br />1 <br />2 <br />HSC 25284 <br />HSC 25292.3 <br />Permit to operate <br />Upgrade: compliance certificate/sticker <br />3 <br />CCR 2711(b) & (c) <br />Current State Form A & B <br />Certification of financial responsibility and letter from chief financial <br />4 <br />HSC 25292.2 <br />officer <br />5_CCR <br />2630 (d) <br />Continuous monitoring system for UST system <br />6_CCR <br />2636 (c)(1) <br />All releases in secondary piping flow to a collection sump <br />7 <br />CCR 2636 (a) <br />Secondary containment for piping is waterproof <br />8CCR <br />2636 (0(2) <br />Automa tic line leak detector(s) <br />9 _CCR <br />2636 (f)(1) <br />Contim ous monitoring system for underground piping <br />10 <br />CCR 2632 (c)(2) <br />Contim ous monitoring system for UST <br />11_HSC <br />25291(a)(2) <br />Secondary containment for UST is tight <br />12 <br />CCR 2636 (f)(1) <br />Continr,�us monitoring system for dispenser system <br />13 <br />CCR 2635 (b)(1) <br />Spill ccniainer <br />14 --CCR <br />2635 (b)(2) <br />Overf.',l prevention system <br />15 <br />CCR 2631 (a) <br />Primar containment is product -tight <br />16_HSC <br />25292.1 <br />UST system is operated to prevent unauthorized release <br />17_CCR <br />2650 <br />Recording/reporting unauthorized release <br />18 <br />CCR 2632 (d) <br />' Monito .ng and response plan <br />19 <br />CCR 2712 (i) <br />Monitoring and response plan is on site <br />20 <br />CCR 2712 (b) <br />Maintenance and monitoring records <br />21 <br />CCR 2636 (f)(4) <br />Annuai dine tightness test <br />22 <br />CCR 2630 (d) <br />Annua' line leak detector test <br />23 <br />CCR 2630 (d) <br />Annual monitoring certification <br />of suction piping that is not continuously <br />24 <br />CCR 2643 (d) <br />Daily monitoring <br />monito -ed <br />1 of <br />PHS 260 (8/04/00) <br />