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SAN JOAQUIN COUNTY <br /> �1VIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, California 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209) 468-3433 Web:www.s ov.or /ehd <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection <br /> Date: <br /> P LA-2-A l�� t�Vit, ,-� zj z <br /> Facility address: UST# r <br /> �C ` _tfi 'IL,ri" -". I�.j � raduct <br /> Facility Contact: Title: Phone: ' <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> 1. <br /> t LLL& cl,1/1Cf ,Pressurized ❑Suction ❑Gravity KMechanical C Audible/visual <br /> Inspection type: Violations: <br /> 3 Routine Monitorin Certification ❑Installation L7 Other: ❑M1-RDetect ❑M2-RPrev U M-3 Both <br /> VIOLATION(S) HSC=California Health& Safety Code; CCR=California Code of Regulations V R <br /> # Code Section V=Violation; RV=Re eat Violation V <br /> 1 HSC 25284 Permit to a erate <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 b & c Current Unified Pro ram 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 b Monitoring Program (Monitoring& Response Plan is current and approved by the local agency. <br /> 6 CCR 2712 i Monitoring Ian is onsite. <br /> 7 CCR 2712 b Maintenance&monitoring records M1 <br /> 8 CCR 2643 d Daily monitoring of suction piping (pre-Janua!y, 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 /> 11 CCR 2630 d UST system monitoringa ui ment is properly located to detect a leak M1 <br /> 12 HSC 25291 b UST system monitoring eq ui ment isoperational M1 <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping& UDC is present M1 <br /> 14 CCR 2631 a Primarycontainment 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 piping flow to a collection sum <br /> 17 HSC 25291 Line leak detectors are installed M1 <br /> 18 CCR 2635 (b)(1) Spill container (M2 <br /> 19 CCR 2635(b)(?)_ Overfill prevention system <br /> M2 <br /> 20 CCR 2636 (a) Conventional suction piping shall have continuous monitoring&20 containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR.2650 Recording/reportingof unauthorized releases M1 <br /> 23 CCR 2715 Designated Operator: a Statement from UST owner; Monthly inspection; Employee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638 a Annual line leak detector test M1 <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test M1 <br /> 28 CCR 2661 Repair for tank/piping-has had tightness test (M2j <br /> 29 CCR 2643 e Biennial tightness test of gravity pipingre-January1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping (pre-January 1, 1984) M1 <br /> 31 HSC 25292.5 Double walls stem located within 1000' of public well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 34 HSC 25298 b Permit to temporarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299 Disabling leak detection devices <br /> a 9 2 <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 3$ 1 Other: <br /> EHD INSPECTOR: PHONE: I;IC <br /> } qC Seatic system: <br /> 4 G 9 Y 3 Serves 2:20 peoplelday <br /> RECEIVED BY: TITLE: a Receives other than sanitary waste <br /> Other di,s osaI methods: <br /> Q wells/French Drains <br /> EHD 23-02-002 REV8108 <br />