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SAN JOAQUIN COUNTY <br /> 4INVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, California 95202-3029 <br /> Telephone: (209) 468-3420 Fax:(209)468-3433 Web:www.sigov.org/ehd <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection <br /> {� Date <br /> 1-9- <br /> Facility address: /' UST# <br /> �EJ✓-lj,ja Aue- Product r+L <br /> Facility Contact: Title: Phone: <br /> rr- <br /> Monitorin Panel: Piping system: Overfill prevention: ' <br /> S 'C' <br /> 11 Pres Suction Gravity echanical Audible/visual <br /> Inspection type: Violations: <br /> outine onitoring Certification ❑Installation ❑Other: ❑M1-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section V <br /> VIOLATION(S) HSC=California Health&Safety Code; CCR=California Code of Regulations V R <br /> V=Violation; RV=Re eat Violation <br /> 1 1 HSC 25284 Permit to operate <br /> 2 1 CCR 2637 Secondary containment test performed <br /> 3 1 CCR 2711 b & c Current Unified Program Consolidated Forms on file with EHD (Facility and tank form <br /> 4 1 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 1 CCR 2632 b Monitoring Program(Monitoring&Response Plan is current and approved b the local agency. <br /> 6 1 CCR 2712 i Monitoring Ian is onsite. <br /> 7 1 CCR 2712 b Maintenance&monitoring records M1 <br /> 8 1 CCR 2643 d Daily monitoring of suction piping (pre-January, 1, 1984 <br /> 9 1 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 1 CCR 2632(c)(2) UST monitoring system is present M1 <br /> 11 1 CCR 2630 d UST system monitoring equipment is properly located to detect a leak M1 <br /> 12 HSC 25291 b UST system monitoring equipment isoperational M1) <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)(1) All releases in secondary pipingflow 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)(2) Overfill revention system 111112 <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/reporting of unauthorized releases M1 <br /> 23 CCR 2715 Designated Operator: a Statement from UST owner; (c-e)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 26364 Annual line tightness test M1 <br /> 28 CCR 2661 Repair for tank/piping has had tightness test (M2 <br /> 29 CCR 2643 a Biennial tightness test of gravity piping(pre-January 1, 1984 <br /> 30' 1 CCR 2643 d Triennial line test for conventional suction piping(pre-January1, 1984) M1 <br /> 31 1 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 1 HSC 25298 b Permit to temp rarily 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 /> 38 Other: <br /> PHONE: UIC <br /> EHD INSPECT / �/ Septic system: <br /> C7 71 ❑Serves>_20 people/day <br /> RECEIVED TITLE:. <br /> 11 Receives other than sanitary waste <br /> Other disposal methods: <br /> S <br /> ❑Dry wells/French Drains <br /> EHD 23-02-002 REV 8/08 <br />