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4�`" • SAN JOAQUIN COUNTY <br /> �oP coc <br /> Q' a ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3`d Floor, Stockton,CA 95202-270 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:wwwsjgov.org/ehd <br /> 9CrFoaa <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM I DSPECTesignated OPON REPORTinspection Date: <br /> Facility name: -n,(�„n� Lt <br /> p i l Z/Z 4/07 <br /> P, <br /> q. G sPm�vs Jel e74°- N/'r/ S <br /> UST# 3 <br /> Facility address: <br /> 1, n mf 1 - ' Product <br /> FO I` Title: Phone: Q <br /> Facility Contact: I ,�— 14u <br /> TW/,4,9,f T►fir�l �VIAPDA) scl(�15>z� I 0 <br /> O-�ve//dill prevention: <br /> Monitoring Panel: Piping system: N,Mechanical ❑Audible/visual <br /> VR T GS 7-CP Gl'1'ressurized ❑Suction ❑Gravity <br /> Violations: <br /> Inspection type: ,,!! ElMl-RD-"^' ❑M2-RPrev El M-3 Both <br /> V4outine "onitonn Certification ❑Installation ❑Other: V R <br /> VIOLATIONS) HSC=California Health&Safety Code;CCR=California Code of Regulations V <br /> # Code Section V=Violation;RV=Re eat Violation <br /> 1 HSC 25284 Permit too crate <br /> 2 CCR 2637 Secondar containment test performed <br /> 3 CCR 2711 (b &(c Current Unified Pro am Consolidated Fomes on file with EHD Facilit and tank form <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632(c 2 (D) Monitorin &res onse Ian is current and filed with the local a enc <br /> 6 CCR 2712 i Monitorin &res onse tan is onsite MI <br /> 7 CCR 2712 b Maintenance&monitorin records 1984 <br /> 8 CCR 2643 d Dail monitorin of suction i in re-7anua , 1, <br /> 9 HSC 25292.1 UST s stem is riper to revent unauthorized release M1 <br /> 10 CCR 2632 c 2 USonitoring system is 2resent MI) <br /> I 1 CCR 2630(d UST s stem monitorin a ui mentis ro erl located to detect a leak M2 <br /> 12 HSC 25291 UST s stem monitorin a ui matt[is o erational Ml <br /> 13 CCR 2636 (1) Continuous monitorin s stem for under ound i in &UDC is resent <br /> 14 CCR 2631 aPrimar containment is product ti ht <br /> 15 HSC 25291 a(2 Seconli=containment for UST is or,ht <br /> 16 CCR 2636 c I All releases in secondary 212JU6flow to a collection sum (MI) <br /> 17 HSC 25291 Line leak detectors are installed M2 <br /> 18 CCR 2635 1 S ill container (M2) <br /> 19 CCR 2635 (b) 2 Overfill prevention system <br /> 20 CCR 2636(a) Conventional suction i ing shall have continuous monitorin &2°containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of Ml <br /> 22 CCR 2650 Recordin re ortin of unauthorized releases Em to ee trainin <br /> 23 CCR 2715 Desi ated O crater: a Statement from UST owner; (c-e)Monthly inspection;(t) <br /> 24 CCR 2638(a Annual monitorin certification (Ml) <br /> 25 CCR 2638(a Annual line leak detector test <br /> 26 HSC 25284.2 Annual s ill containment testIn Ml <br /> 27 CCR 2636( 4) Annual line ti htness test M2 <br /> 28 CCR 2661 Re air for tank/ i in has had ti htness test <br /> 29 CCR 2643 e) Biennial ti htness test of avity piping( re-Jana 1984 1, ) Ml <br /> 30 CCR 2643 d Triennial line test for conventional suction pi2mg 1prc-.131-arY1, 1984 <br /> 31 HSC 25292.5 Double walls stem located within 1000' of ublic well-ELD <br /> 32 CCR 2661 Permit to r air UST s stem <br /> 33 HSC 25286 a Permit to alter monitorin system <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 Disablin leak detection devices <br /> 37 HSC 25298 a) fileal abandonment of UST s stem <br /> 38 Other. UIC <br /> PHONE: Se++tic system: <br /> EHD INSPEC OR: U-6t— 33 <br /> ❑Serves people/day <br /> TITLE: [i Receives <br /> es o other than sanitary waste <br /> REC BY: r Other disposal methods: <br /> Al C 1 t D � d r ❑D wells/French Drains <br /> ElM23-02 <br /> 1nm7 <br />