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• SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMEN <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209) 468-3433 Web:www.s'gov.org/ehd <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator:Exp. Date: Inspection Date: <br /> 7-Eleven 14117 Meredith Poteran 312109 1 4118108 <br /> Facility address: TANK#4 TANK#5 i TANK# TANK# <br /> 2725 Country Club Blvd., Stockton CA Gasoline 87 Gasoline 91 <br /> Facility Contact: Title: Phone: TANK# TANK# TANK# TANK# <br /> IAN MOORHEAD ENV COMP MGR (916)463-6776 <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> VR TLS-350 ® Pressurized ❑Suction ❑Gravity ®Mechanical ❑Audiblelvisual <br /> Inspection type: Violations: <br /> ® Routine M Monitoring System Certification ❑ Installation ❑ Other: ❑M1-RDetect ® M2-RPrev ❑ M-3 Both <br /> # Code Section VIOLATION(S) HSC=California Health &Safety Code; CCR=California Code of Regulations V R <br /> V=Violation; RV=Re eat Violation I V <br /> 1 HSC 25284 Permit to operate ❑ ❑ <br /> 2 CCR 2637 Secondary containment test performed ❑ ❑ <br /> 3 CCR 2711 b & c Current Unified Program Consolidated Forms on file with EHD(Facility,Tank, Monitorin /Res onse ❑I ❑ <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter ❑I ❑ <br /> 5 CCR 2632 c 2 D Monitoring& response plan is current and filed with the local agency ❑I ❑ <br /> 6 CCR 2712 i Monitoring& response plan is onsite ❑I ❑ <br /> 7 CCR 2712 b Maintenance& monitoring records (M1) ❑I ❑ <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release ❑I ❑ <br /> 10 CCR 2632(c)(2) UST monitoring system is present (Mi) ❑I ❑ <br /> 11 CCR 2630 d UST system monitoring equipment is properly located to detect a leak M1 ❑1 ❑ <br /> 12 MSC 25291 b UST system monitoring equipment is operational (M2) ❑ ❑ <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping& UDC is present (M1) ❑ ❑ <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)(`IAll releases in secondary pipingflow to a collection sump ❑ ❑ <br /> 18 CCR 2635(b)(1) Spill container (M2) El I ❑ <br /> 19 CCR 2635(b)(2) Overfill prevention system (M2) ❑1 ❑ <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of ❑I ❑ <br /> 22 CCR 2650 Record in /reporti ng of unauthorized releases (MlL ❑ ❑ <br /> 23 CCR 2715 Designated Operator: a Statement from UST owner; (c-e Month) inspection; Employee training ❑ ❑ <br /> 24 CCR 2638 a Annual monitoringcertification ❑ ❑ <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 (M1) ❑ ❑ <br /> 28 CCR 2661 Repair for tank/pipinghas had tightness test M2 ❑ ❑ <br /> 131 HSC 25292.5 Double walls stem located within 1000' of public well-ELD ❑ ❑ <br /> 32 CCR 2661 Permit to repair UST system ❑ ❑ <br /> 34 HSC 25298 b Permit to temporarily close UST system ❑ ❑ <br /> 36 HSC 25299(a)(9) Disablingleak detection devices ❑ ❑ <br /> 37 HSC 25298 a) IIIc al abandonment of UST system ❑ ❑ <br /> 38 CCR 2638(d) Monitoringsystem certification test report submitted within 30 days. ❑ ❑ <br /> 39 CCR 2637(e) Secondarycontainment test report submitted within 30 days. ❑ ❑ <br /> 40 HSC 25290.1 Seconda containment prevents an water intrusion after Jul 1, 2004 ❑ ❑ <br /> 41 HSC 25290.2 Secondarycontainment prevents an water intrusion after Jul 1, 2003 and before Jul 1,2004 ❑ ❑ <br /> 38 Other: <br /> ❑t ❑ <br /> EHD INSPECTOR: PHONE: a tics stem: UIIC ❑ <br /> Ray von Flue 209 468-9Q48 10 Serves>20 people/day <br /> RECEIVED BY: TITLE: ❑ Receives other than sanitary waste <br /> Other dis oral methods: <br /> ❑ <br /> Dry wells7French Drains <br /> EHO 23-02-002 Page 1 <br /> 3/13/2008 <br />