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SAN JOAQUIN COUNTY <br /> ��ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3rd Floor,Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Far.(209)468-3433 Web:www.sigov ore/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> i RptL`� �C�1T� tr.JCi mac. (vU--VeR- ii_2---0-1 <br /> Facility address: <br /> ytoo UST# . 3 <br /> Product D <br /> Facility Contact: Title: Phone: <br /> VA"dA �JlnKwrV /VlAi.IAGt� Q'�`E-1220 <br /> WrTg Panel. � Piping system: Overfill prevenHon- <br /> IWC Pressurized ❑Suction ❑Gravity ❑Mechanical )(Audible/visual <br /> Inspettron type: Violations: <br /> Routine onitorin Certification ❑Installation ❑Other: 1 ❑MI-RDeuct ❑M2-RPrev ❑M-3 Both <br /> # Code Section VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> V=Violation;RV=Re eat Violation V <br /> I I HSC 25284 Permit too rate <br /> 2 1 CCR 2637 Second2a containment test perfia <br /> 3 CCR 2711 6 & c Current Unified Pro am Consolidated Forms on file with EHD(Facility and tank form <br /> 4 HSC 25292.2 Certification of financial res onsibili and CFO letter <br /> 5 CCR 2632 c 2 D Monitorin &response plan is current and filed with the local agency <br /> 6 CCR 2712(i) Monitoring&response plan is onsite <br /> 7 CCR 2712 6 Maintenance&monitoring records Ml <br /> 8 CCR 2643 d Dail nwnitorin of suction piping(pre-January, 1, 1984 <br /> 9 HSC 25292.1 UST system is operated to prevent unauthorized release <br /> 10 CCR 2632(cX2) UST monitoring system is present Ml <br /> I I CCR 2630 d UST s stem monitoring equipment is proper] located to detect a leak Ml <br /> 12 HSC 25291 UST system monitoring Equipment isoperational M2 <br /> 13 CCR 2636 1 Continuous monitorine system for underground pi2ing&CDC is present Ml <br /> 14 CCR 2631 a Primary containment is product tight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in secondary pipingflow to a collection sum <br /> 17 HSC 25291 Line leak detectors are installed Ml <br /> I S CCR 2635 1 Spill container M2 <br /> 19 CCR 2635(b)(2) Overfill prevention system M2 <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitorin &20 containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reptarting of unauthorized releases Ml <br /> 23 CCR 2715 Desi natedOperator: a Statement from UST owner; (c-e)Monthly inspection; f)Employee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638 a Annual line leak detector test MI <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test Mi <br /> 28 CCR 2661 Repair for tank/piping has had tightness test (M2 <br /> 29 CCR 2643 a Biennial tightness test of gravity pipingre-Januar 1, 1984 <br /> 30 CCR 2643(d) Triennial line test for conventional suction piping(pre-January1, 1984 (Ml <br /> 31 HSC 25292.5 Double wall system located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit tore air UST system <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 34 HSC 25298 Permit to temporarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299(a)(9) Disablingleak detection devices <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other: <br /> END INSPECTOR: PHONE: UIC <br /> W I LA-j Iii fig-WL4 Septic system <br /> ❑Serves 2!20 people/day <br /> RECETV TITLE: Receives other than sanitary waste <br /> co <br /> } �� Other disposal methods <br /> b-�1/lA Dry wells/French Drains <br /> EHD 23-02-002 <br />