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0 <br />r: <br />SAN JOiAQllI:N COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East -Weber Avenue, 3d Floor, Stockton, CA 95202-2708 <br />Telephone: (209.) 468-3420 Fox; (209) 468-3433 Web: mmwff.sjgoyorg <br />3 () (�AY <br />UNDERGROUND STORAGE TANK ST PROGRAM INSPECTION "PORT <br />Facility name: <br />Designated Operator: <br />Inspection bate: <br />Facility address; r y ( y <br />UST# <br />'Product <br />4�'J (� <br />r rF{`# <br />Facility Contact: Titter Phibne; <br />wr~ <br />Monitoring Panel: Y <br />/ L i i j <br />piping systemi <br />y <br />t Pres:;urizcd 'Suction ❑ Gravity <br />Owerf ll prevention: <br />2 Mechanical ❑ AudibleNisual <br />- �• <br />18peetion type. ��", <br />,Routine i 44onitorin Certification ❑ Installation ❑ Other: <br />YVlatl�— <br />M1-RDctcct ❑ M27RPrcv ❑ M-3 Both <br />VIOLATION(S) HSC�ahfomia Health & Safety Code; CCR=California Code of Regulations V R <br /># Cock Section V=Violation, RV=Re cat Violation V <br />- - — - <br />1 HSC 25284 Permit to oRerate <br />:: ..:. 2'63 ". :' f ..cbn tatidittrnent test:, erforrtted <br />3 CCR 2711 (b) & c Current Unified Pro atn Consolidated Fonns on file with EHD (Facilily,Lnd tank Loan <br />CCrhfi�ixiivir��fina¢tcial� nsibiHjY,'arid 'CFC1'16tkcr' . . <br />5 CCR 2632 c 2 Monitoring & res onse plan is current and filed with the local.a enc <br />712, r ,..: '" .. lsritiilyiorfn iT... Se `lan:i.dnsitc.' . <br />7 CCR 2712 Maintenance & monitorin recordsI <br />Isl ineziiatiri asuetisn' i ' e=Satlrl ;"1:'1984.... - <br />9 HSC 25292.1 UST system iso rated to prevent unauthori2ed release <br />1 CCR 2630 d UST "ern em monitorin equipment is properly located to detect a leak 1 <br />5" sm:tnvtiikvrii s. it .. cnt:is a crati4nat <br />13 CCR 2636 1 Continuous monitorina system for under ound piping & UDC is presenT 1 <br />14 ; : :CC$ 2$5 L` 1?ri ghltfytiiitil2tYt;(S rtis3tt'et 1i <br />15 HSC 25291 a 2 Secondary containment for UST is tight <br />2 = :�.... , ;41�,�oloa-Ons3tiSeG�i iiti 'floes tb a co116ccioi':s o ', ., .:.. ." <br />17 HSC 25291 Line leak detectors are installed I <br />..:+.,V <br />19 CCR 2635 2 Overfill Preverition system (A3 <br />.�,4 � ��C+� a .. cotrti7iututs monito <br />y' (.i ": C rYirt-11'66 l adeehon. t err :slrskl have <br />._ a... ,. _ <br />21 HSC 25291 (e) Water in 20 containment anal ed & properly disposed of <br />2 SCR fib° Z Cord-- .r rift "oof u'nnthorizedi „ : �y .; <br />releases sc- .,::- : .', ,.. .., <br />CaappCRy Desiaced rator; a. Statement from UST owner; o -e Monthl ins cctiorr,'( E jn to e�G trainin <br />X243 22715} <br />25 CCR 2638 a Annual line leak detector test �,........... <br />3 <br />Ikeon�lnrr�dt::tt�tran . , ., ,.,. <br />27 CCR 2636 4 Annual line tightness test I <br />MM' , : _'D'CV2661i: <br />29 CCR 2643 a Biennial tightness test of gravitY PiRingre-Jan 1 1984 <br />, <br />�"t�.. .`CGRZ643 d ..::...`,t .-'T"r�er7i`ial°liii�#�t'f�cprvei�tiitaa�l strctiiois ii tc-Jeno �1�8 ;'��"` i <br />31 HSC 25292.5 Double wall s stem located within 1000' of ublic well-ELD <br />r' <br />33 HSC 25286 (a) Permit to alter monitoring system <br />„ ... <br />`T�trirrtrtii <br />35 HSC 25298 c Permit to close UST system <br />9a <br />:3.6 BSC. i2529Q " :17 alti3ihi';1e�lydefectiiondeiiices' <br />37 HSC 2529$ a Illegal abandonment of UST system <br />C. <br />EHD INSPECTOPt: "ti �~ <br />PHONE._ <br />UIC <br />SMOG system: <br />❑ Serves >2o people/day <br />❑ Receives other than sanitarywaste <br />Cather disposal methods: <br />0 Dry wells/French Drains <br />"(I BY:: � <br />.'1 +' <br />. • :. i' '` r - ' ? " <br />TITLE: � <br />r/ E <br />r 1 'ti 4 ,:. <br />EHD 23-02-002 <br />8 <br />Id 99H I CN 8tN-N-6N ' dSNVH HOA Wb'E 1 6 <br />