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SAN JOAQUIN COUNTY <br /> VIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton,CA 95202- Q8 <br /> Telephone:(209)468-3420 Fax: (209)468-3433 Web: wwwL ov.or ehd <br /> Facility name: UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Designated Oerator: tjat � Inspection pate: <br /> �Z4b1�L—V�. <br /> Facility address: S/ <br /> UST# <br /> Facility Contact: - Product <br /> Title: Phone: <br /> if <br /> ZIMA <br /> M nitoring Panel: Pi 'ng system: <br /> Ov fill Prevention: <br /> Pressurized Ll Suction Q Gravi � ,,/, <br /> Ins ection type: 17mechanical iCJ R,udible/visual <br /> Routine MonitoringCertification Vio tions: <br /> Ll 11 Other: <br /> M1-RDetect ❑M2-RPrev Q M-3 Both <br /> # Code Section VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations <br /> V R <br /> I HSC 25284Permit too erste V='Violation;RV=Re eat Violation V <br /> 2 CCR 2637 Second containment test erformed <br /> 3 CCR 27'' b)&(c Current Unifed Pro ram Consolidated Forms on file with EHD(Facilit and tank form <br /> 4 HSC 25292.2 Certification of financial res onsibilit and CFO letter <br /> 5 CCR 2632 c 2 D) Monitorin &res onse plan is current and filed with the local a enc <br /> 6 CCR 2712(i) Monitorin &res onse 2lan is onsite _ <br /> 7 CCR 2712(b) Maintenance&monitorin records <br /> 8 CCR 2643 (d) Dai!y monitoring of suction pi_ re-lams 1, 1984) M1 <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632 c 2 UST monitorin system is present <br /> I I CCR 2630(d) UST system monitorin a ui meni is ro erl located to detect a leak MI) <br /> 12 HSC 25291 b UST s stem monitorin a ui ment isoperational Mi <br /> 13 CCR 2636 f) 1 Continuous monitorin ­q.—for under ound i in & UDC is resent M2 <br /> 14 CCR 2631 a) Primar containment is product ti ht MI <br /> 15 HSC 25291 (a 2) Seconder containment for UST is ti ht <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 <br /> 18 CCR 2635(b)(1) S ill container Ml <br /> 19 CCR 2635(b (2) Overfillrevention s stem (M2 <br /> 20 CCR 2636(a) Conventional suction i in shall have continuous monitorin &20 containment M2 <br /> 21 HSC 25291 (c) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Record in re ortin of unauthorized releases <br /> 23 CCR 2715 Desi noted O erator:(a) <br /> 24 CCR 2638 a Statement from UST owner; (C-e)Monthlyinspection; f)Em to cc trainin MI <br /> Annual monitorin certification <br /> 25 CCR 2638(a) Annual line leak detector test <br /> 26 HSC 25284.2 Annuals ill containment testing (MI) <br /> 27 CCR 2636(f) 4 Annual line ti htness test <br /> 2$ CCR 266I (f) Re air for tank/ i inE has had tight Ss test M1) <br /> 29 CCR 2643(e Bienn±ti htness test of gravity PiRingre-Janus 1, 1984 (MZ <br /> 30 CCR 2643d <br /> ( ) Triennial Cine test for conventional suction f in ( re-Jams 1, 1984 <br /> 31 HSC 25292.5 Double walls stem located tvithin 1000'of ublic well-ELD (M1 <br /> 32 CCR 2661 Permit to re air UST s stern <br /> 33 HSC 25286(a) Permit to alter monitorin s stem <br /> 34 HSC 25298 ) Permit to tem oraril close UST s stem <br /> 35 HSC 25298(c) Permit to close UST s stem <br /> 36 HSC 25299(a)(9) Disabling leak detection devices <br /> 37 HSC 25298 a) Illegal abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR: <br /> PHONE:�� o <br /> RECEIVEDERECEIVEDBY: S tic system' UIC <br /> Serves>_20 people/day <br /> TITLE: a Receives other than sanitary waste <br /> Other disaosal methods: <br /> Dry wells/French Drains <br /> FHr)23-02-002 <br />