Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMEN' <br /> 304 East Weber Avenue,3`d Floor,Stockton,CA 9520 -2708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web: www.sigov.orp/e <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facilih name Designated Operator: Inspection Date: <br /> A gp�las rA�1Bn) D m T �n1,gs T/ Y 212s�1o6 <br /> Facility address: UST# S <br /> 4K <br /> e� 3 4- <br /> 4 0OD S A" ar (. *(-A Product ` AV CV4 <br /> Facility Contact: Title: Phone: <br /> TAA 1119e 917FW6,19 1S2-15siti <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> V rjes ""ressurized ❑Suction ❑Gravit LR�Mechanical Sd�Audible/visual <br /> Inspection type: __// Violations: <br /> 5,4outine LWNlonitorin Certification ❑Installation ❑Other: ❑Ml-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section V=Violation;RV=R eat Violation V <br /> I HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondarycontainmenttest performed <br /> 3 CCR 2711 6 & c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br /> 4 HSC 252923 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 c 2 D Monitoring&response plan is current and filed with the local agency <br /> 6 CCR 271 2 i Monitoring&res nseplan is onsite <br /> 7 CCR 2712 b Maintenance&monitoringrecords Ml <br /> 8 CCR 2643 d Dail. monitoringof suction piping(pre-January, 1, 4984 <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> ]0 CCR 2632 c 2 UST monitoringsystem is resent Ml <br /> 1 I CCR 2630 d UST-tem monitorin a ui mentis properly located to detect a leak Ml <br /> 12 HSC 25291 UST s stem monitorin ui ment iso erational M2 <br /> 13 CCR 2636 1 Continuous monitoringsystem for underground piping&UDC is resent MI <br /> 14 CCR 2631 a Prim 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 second piping flow to a collection sum <br /> 17 HSC 25291 Line leak detectors are installed MP' <br /> I8 CCR 2635 b 1 Spill container (M2) <br /> 19 CCR 2635 2 Overfill prevention s stem M2 <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recordin /r orcin of unauthorized releases Ml <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 (MI) <br /> 26 HSC 25284.2 Annual spill containment testing <br /> 27 1 CCR 2636 4 Annual line tightness test MI <br /> 28 CCR 2661 Re air 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 CCR 2643 d Triennial line test for conventional suction piping(pre-January 1, 1984) (MI <br /> 31 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 HSC 25298 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 /> Ent of UST system <br /> 38 Other. <br /> EHD INSPECTOR: PHONE: UIC <br /> • / Z0 " fw —M�G Septic system: <br /> ,I I0 l 7J T 7 1 11 Serves 220 people/day <br /> REC BY: ITLE: ❑Receives other than sanitary waste <br /> �,I�+ O N S�`7a�'v� Other disposal methods: <br /> ��11 ❑Dry wells/French Drains <br /> EHD 23-02-002 <br />