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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT 4/ <br /> 304 East Weber Avenue,3rd Floor,Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:vnvw.s+gov.org/ <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> 3 <br /> # <br /> Facility address: UST <br /> Product <br /> Facility Contact: Title: Phone: <br /> M itoring Panel:' Pi ing system: O rfill prevention: <br /> Pressurized D Suction D Gravityechanical D Audible/visual <br /> ession ype: iolations: <br /> Routine )(MonitoringCertification D Installation G Other: D MI-RDelect ❑M2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section V=Violation;RV-Re eat Violation V <br /> I HSC 25284 Permit too rate <br /> 2 CCR 2637 secondary containment test erformed <br /> 3 1 CCR 2711 6 & c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 c 2 D Monitoring&res once plan is current and filed with the local agency <br /> 6 CCR 2712 i Monitoring&res nse plan is onsite <br /> 7 CCR 2712 6 Maintenance&monitoring records M1 <br /> 8 CCR 2643(d) Daily monitoring of suction piping(pre-January, 1, 1984) <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present M1) <br /> 1 I CCR 2630 d UST system monitoring equipment is properly located to detect a leak M 1 <br /> 12 HSC 25291 UST system monitoring equipment isoperational M2) <br /> 13 CCR 2636 (1) Continuous monitoring system for underground piping&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 /> 18 CCR 2635(b)(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 monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized reieases Ml <br /> 23 CCR 2715 Designated Operator: 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 Ml <br /> 28 CCR 2661 ( Repair for tank/piping has had tightness test (M2 <br /> 29 CCR 2643 a Biennial tightness test of gravity piping( re-Januar 1, 1984) ? <br /> 30 1 CCR 2643 d Triennial line test for conventional suction pi in re-Jana 1, 1984 (Ml) <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to repair UST system -4 <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) Disabling leak detection devices <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other: <br /> END INS PHONE: UIC <br /> Septic system: <br /> u Serves>_20 people/day <br /> RECEIVED TITLE: Receives other than sanitary waste <br /> (V�t Other disposal methods <br /> I _ �Q� wells/French Drains <br /> EHD 23-02-002 <br />