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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,California 95202-3029 <br /> Telephone: (209)468-3420 Fax:(209)468-3433 Web:www.sjgov.orWehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Ope�jator: Ins ection at(e,�: <br /> qn U e U� NUS I`4' <br /> Facility address: UST# <br /> y r (,++,► Product <br /> Facility Contact: Title: Phone: ' <br /> I C'l SI LA <br /> onitoring Pan : r Piping system: Overfill prevention: <br /> Pressurized ❑Suction ❑Gravity echanical ❑Audible/visual <br /> Ni'mations: <br /> inspection type: <br /> Routine Monitorin Certification ElInstallation ❑Other: F1MI-RDetect 2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC–Califomia Health&Safety Code;CCR=California Code of Regulations V R <br /> V=Violation; RV=Re eat Violation <br /> 1 HSC 25284 Permit tooperate <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 fonn) <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 a enc . <br /> 6 CCR 2712(i) MonitorinE plan is onsite. <br /> 7 CCR 2712 b) Maintenance&monitoringrecords (M1 <br /> 8 CCR 2643 d) Daily monitoring of suction 2iping(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 /> I 1 CCR 2630 d) UST system monitorinE equipment is properly located to detect a leak MI) <br /> 12 HSC 25291 b) UST system monitoring equipment isoperational (M2) <br /> 13 CCR 2636(t)(1) Continuous monitoring system for underground piping&UDC is present M l <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 piping flow to a collection sum <br /> 17 HSC 25291 f Line leak detector(s)are installed (M I) <br /> 18 CCR 2635(b)(1) Spill container M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system (MZ <br /> 20 CCR 2636(a) Conventional suction 2iping shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 RecordinE/reporting of unauthorized releases MI) <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly inspection-, f1 Employee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> (M1) <br /> 25 CCR 2638(a) Annual line leak detector test <br /> 26 HSC 25284.2 ,Annuals ill containment testing <br /> 27 CCR 2636(t)(4) Annual line tightness test (M I) <br /> 28 CCR 2661 (t) Repair for tank/pipinghas had tightness test (N12} <br /> 29 CCR 2643(c) Biennial tightness test of gravity pi2ingre-Janus 1, 1984) <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping( re-Janus 1, 1984) (Ni1) <br /> 31 HSC 25292.5 Double walls stern located within 1000"ofpublic 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 a)(9)_ Disabling leak detection devices <br /> 37 HSC 25298 a) Illegal abandonment of UST system – <br /> 38 Other: <br /> 714�-4 <br /> NSPECTOR: PHONE: UIC <br /> 1204) <br /> -12 �f 5e tic tem:7( l0 -110 Serve 0 people/day <br /> RECEIVED Y: TITLE: –Receives er than sanitary waste <br /> Other disposal meth <br /> 4, Z— h/�� _Dry wellsTrIencb ns <br /> EHD 23-02-002 REV 05107 <br />