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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, Yd Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sijzov.orgjehd <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility name. <br />Designated Operator: <br />Inspection Date: <br />Facility address: // r�� <br />'S� \313. CCL\-�►l��G r"'`�• <br />UST # <br />Product <br />C\ <br />Facility Contact. <br />Title: Phone: <br />, <br />14Nonitoring Panel:Pi <br />R \\a YOD <br />ng system: <br />7ressurized El Suction ❑ GravityW <br />Ove%�ill prevention: <br />echanical ❑ Audible/visual <br />7ouInspetype: <br />tine ❑ Monitoring Certification ❑ Installation ❑ Other: <br />Vtions: <br />Vitions: <br />MI-RDetect ❑ M2-RPrev <br />❑ M-3 Both <br /># Code Section <br />VIOLATIONS) HSC=California Health & Safety Code; CCR=Califomia Code of Regulations <br />V=Violation; RV=Re eat Violation <br />V R <br />\, <br />I HSC 25284 <br />Permit tooperate <br />2 CCR 2637 <br />Secondary containment test performed <br />3 CCR 2711 b & c <br />Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br />4 HSC 25292.2 <br />Certification of financial responsibility and CFO letter <br />5 CCR 2632 c 2 D <br />Monitoring & response plan is current and filed with the local agency <br />4 <br />6 CCR 2712 J <br />Monitoring & response plan is onsite <br />7 CCR 2712 6 <br />Maintenance & monitoring records <br />M1 <br />8 CCR 2643 d) <br />Daily monitoring of suction piping (pre -January, 1, 1984 <br />9 1 HSC 25292.1 <br />UST system isoperated to prevent unauthorized release <br />10 CCR 2632 (c)(2) <br />UST monitoring system is present <br />Ml <br />11 CCR 2630 d <br />UST system monitoring equipment is properly located to detect a leak <br />Ml <br />12 HSC 25291 <br />UST system monitoring equipment isoperational <br />M2 <br />13 CCR 2636 1 <br />Continuous monitoring s stem for underground piping & UDC is present <br />M1 <br />14 CCR 2631 a <br />Primary containment is product tight <br />15 HSC 25291 (a)(2) <br />Secondary containment for UST is tight <br />16 CCR 2636 (c)(1) <br />All releases in secondary pipingflow to a collection sum <br />17 HSC 25291 <br />Line leak detectors are installed <br />M1 <br />18 CCR 2635 (1) <br />Spill container <br />(M2 <br />19 CCR 2635 b)(2) <br />Overfill prevention system <br />M2 <br />20 CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 2° containment <br />21 HSC 25291 (e) <br />Water in 20 containment analyzed & properly disposed of <br />22 CCR 2650 <br />Recording/reporting of unauthorized releases <br />Ml <br />23 CCR 2715 <br />Designated Operator: (a) Statement from UST owner; (c -e) Monthly inspection; (f) Employee training <br />24 CCR 263$ a <br />Annual monitoring certification <br />25 CCR 2638 a) <br />Annual line leak detector test <br />(Mi) <br />26 HSC 25284.2 <br />Annuals ill containment testing <br />27 CCR 2636 4 <br />Annual line tightness test <br />Ml <br />28 1 CCR 2661 <br />Repair for tank/piping has had tightness test <br />M2 <br />29 CCR 2643 a <br />Biennial tightness test of gravity pipingre-Janus 1, 1984 <br />30 CCR 2643 d <br />Triennial line test for conventional suction piping (pre -January 1, 1984) <br />(Ml <br />31 HSC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <br />32 CCR 2661 <br />Permit to repair UST system <br />33 HSC 25286 (a) <br />Permit to alter monitoring system <br />34 1 HSC 25298 b) <br />Permit to temporarily close UST system <br />35 HSC 25298 c <br />Permit to close UST system <br />-36 HSC 25299 (a)(9) <br />Disabling leak detection devices <br />37 HSC 25298 a <br />Illegal abandonment of UST system <br />38 Other: <br />EHD INSPECTOR: `I <br />PHONE: UIC <br />00�5-1 1 Septic system: <br />Serves >_20 people/day <br />TITLE: Receives other than sanitary waste <br />Other disposal methods: <br />C/ ❑ Dry wells/French Drains <br />RECEIVED BY: <br />EHD 23-02-002 <br />