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SAN JOAQUIN COUNTY <br />NVIRONMENTAL HEALTH DEPARTMENT <br />304 Weber Avenue, 3rd Floor, Stockton, CA 952 4 708 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/eh <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />(tv n , <br />ame: Dessigfnated Operator: Inspe-ctti�o)n I)atc: <br />Facility add s: <br />S <br />V3 <br />Facility Contact: <br />Title: Phone: <br />,:::#r.d <br />Monitor Panel: <br />Piping system:vention: <br />l ❑ Audiblelvisual <br />ressurized� SuctioGravity <br />Vrype: <br />Violations: <br />��O'utine onitoring <br />Certification L Installation L Other, ❑ Ml -R Detect ❑ M2-RPrev <br />❑ M-3 Both <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=California Code of Regulations <br />V R <br />V <br /># <br />Code Seetlon <br />V=Violation; RV=Re eat Violation <br />1 <br />HSC 25284 <br />Permit tooperate <br />2 <br />CCR 2637 <br />Second containment test performed <br />3 <br />CCR 2711 b & (c) <br />Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br />4 <br />HSC 25292.2 <br />Certification of financial responsibility and CFO letter <br />5 <br />CCR 2632 c 2 D <br />Monitoring & res onse plan is current and filed with the local agency <br />6 <br />CCR 2712 (i) <br />Monitoring & response plan is onsite <br />7 <br />CCR 2712 (b) <br />Maintenance & monitoring records <br />(1471) <br />8 <br />CCR 2643 (d) <br />Daily monitoring of suction piping (pre -January, 1, 1984) <br />9 <br />HSC 25292.1 <br />UST system isoperated to prevent unauthorized release <br />10 <br />CCR 2632 c)(2 <br />UST monitoringsystem is resent <br />MI ) <br />11 <br />CCR 2630 d) <br />UST system monitoring equipment is properly located to detect a leak <br />(MI <br />12 <br />HSC 25291 b <br />UST system monitoring equipment isoperational <br />M2) <br />13 <br />CCR 2636 (f)(1) <br />Continuous monitoring s stem for underground piping & UDC is present <br />MI <br />14 <br />CCR 2631 a) <br />Primary containment is product tight <br />15 <br />HSC 25291 a)(2) <br />Secondary containment for UST is tight <br />16 <br />CCR 2636 (c)(1) <br />All releases in secondary piping flow to a collection sum <br />17 <br />HSC 25291 0 <br />Line leak detector(s) are installed <br />(Ml) <br />18 <br />CCR 2635 (b)(1) <br />Spill container <br />(MZ) <br />19HSC <br />2635 (b)(2) <br />Overfill prevention system <br />M2 <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitorin & 2° containment <br />dCCR <br />21 <br />25291 (e) <br />Water in 2° containment analyzed & properly disposed of <br />22 <br />CCR, 2650 <br />Recordin re ortin of unauthorized releases <br />Nil <br />23 <br />CCR 2715 <br />Desiagated Operator: (a) Statement from UST owner; (c -e) Monthly inspection; {fj Em io ee training <br />24 <br />CCR 2638 a <br />Annual monitorinS certification <br />25 <br />CCR 2638 a) <br />Annual line leak detector test <br />—testing <br />'M1) <br />26 <br />HSC 25284.2 <br />Annuals ill containment <br />27 <br />CCR 2636 4 <br />Annual line tightness test <br />M1 <br />28 <br />CCR 2661 (f) <br />Repair for tank/piping has had tightness test <br />(M2 <br />29 <br />CCR 2643 e <br />Biennial tightness test of gravity 2ipingre-Januar 1, 1984) <br />30 <br />CCR 2643 d <br />Triennial line test for conventional suction piping (pre -January 1, 1984 <br />Ml <br />31 <br />HSC 25292.5 <br />Double walls stem located within 1000' of public Weil-ELD <br />32 <br />CCR 2661 <br />Permit to repair UST system <br />33 <br />HSC 25286 a <br />Permit to alter monitoring system <br />34 <br />HSC 25298 <br />Permit to temporarily close UST system <br />35 <br />HSC 25298 (c) <br />Permit to close UST system <br />.36 <br />HSC 25299 (a)(9) <br />Disabling leak detection devices <br />37 <br />HSC 25298 a) <br />Illegal abandonment of UST system <br />38 <br />Other: <br />UIC <br />EHD I' SPECTd0 <br />PRONE: ,ry <br />j(() Se tic s s <br />LIU—I ry s <br />eo ay <br />RE <br />EIVED BY: <br />TITLE: ve er than sanitary waste <br />Other sal methods: <br />I - Dry wells/French Drains <br />EHD 23-02-002 <br />