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' <br /> SAN JUAQUIN COUNTY 46 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax. (209)468-3433 Web:www.sit;ov.orPlehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> Facility address: / <br /> b (� CSI r1 'Product <br /> � s <br /> Facility Contact: / Title: r- Phone: /r ' <br /> Monitoring Panel: Piping 'Stem: Overfill prevention: <br /> a 22 Vpressurized ❑Suction ❑Gravity C7 Mechanical LIXudible/visual <br /> Violations: <br /> Inspection type: <br /> l ou[ine Ll Monitoring Certification L7 Installation 0 Other: ElMI-RDetect fl M2-RPrev ElM-3Both <br /> alifornia Cade of Regulations NV R <br /> # Code Section <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=CV <br /> V=Violation; RV=Re eat Violation <br /> I HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 b)& c Current Unified Program Consolidated Forms on the with EHD(Facilityand tank form) <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 b) Monitorin Program Monitorin &Res onse Plan)is current and approved by the local agency. A <br /> 6 CCR 2712 i) Monitoting plan is onsite. M1 <br /> 7 CCR 2712 b Maintenance&monitoring records <br /> 8 CCR 2643 d) Dail monitoring of suction piping(pre-Jan ary, 1, 1984) <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632 c) 2) UST monitoringsystem is resent (M 1) <br /> 11 CCR 2630 d) UST system monitoringa ui tnent is properly located to detect a leak M 1) <br /> 12 HSC 25291 b) UST system monitoringequipment isoperational <br /> (M2} <br /> 13 CCR 2636 t) l Continuous monitoring system for underground piin &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 detector(s)are installed (M 1) <br /> 18 CCR 2635 b) 1) S ill container (M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system (MZ) <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Recordin /re ortin of unauthorized releases Ml) <br /> 23 CCR 2715 Desi hated Operator:(a)Statement from UST owner; (c-e)Monthly inspection-(t) Employee trainin <br /> 24 CCR 2638 a Annual monitoring certification (M1) <br /> 25 CCR 2638(a) Annual line leak detector test <br /> 26 HSC 25284.2 Annuals ill containment testing (M1) <br /> 27 CCR 2636(f)(4) Annual line tightness test (M2) <br /> 28 CCR 2661 t) Repair for tank/piping has had tightness test <br /> 29 CCR 2643 e) Biennial ti htness test of gravity pipingre-Janus 1, 1984) (tl1) <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping(re—January 1, 1984) <br /> 31 HSC 25292.5 Double walls stem located within 1000'orpublic 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. UIC <br /> EHD INSPECTOR: PHONE: <br /> ��(/�3�� � Seutic system: <br /> A4 - o -Senes?20 people/day <br /> REC D BY-. TITLE: -Receives other than sanitary waste <br /> _011ier dosal methods: <br /> wellslFrench t3rams <br /> EHD 23-02-002 REV 05/07 <br />