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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMEN <br /> 304 I,'"t Weber Avenue,3rd Floor, Stockton,CA 9520 708 <br /> Telephone.(209)468-3420 Fax:(209)468-3433 Web:www.siizov.org/c <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> 11A.GKPOT FOOD Kh+RT TIME zlt — �. 6aBP-s* ) tq-3.AS 1 4!1=1y* d4-21-D6 <br /> Facility address: UST# 4 <br /> 1L{H0O E'- FIWY 6� , v—bGKeI�OYiD Product <br /> Facility Contact: Title: Phone: <br /> SltVl L-lit-sem ..�R6rr.'tZ 2°99.24 SMYl-(2--- <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> dIz TL-S 3sa Pressurized D Suction D Gravity Mechanical D Audible/visual <br /> Ins ection type: Violations: <br /> outine Alonitoring Certification D Installation D Other: Ml-RDetect D M2-RPrev D M-3 Both <br /> # Code Section <br /> VIOLATIONS) HSC=Califomia Health&Safety Code;CC =Califomia Code of Regulations V R <br /> V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR2637 Secondary containment test performed <br /> 3 CCR 2711 6 & c Current Unified Program Consolidated Forms on file with END(Facility and tank form) <br /> 4 HSC 25292.2 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 2712 i Monitoring&response pplan is onsite <br /> 7 CCR 2712 6 Maintenance&monitoring records M1 ✓ <br /> 8 CCR 2643(d) Daily monitoring of suction piping(pre-January, 1, 1984) <br /> 9 HSC 25292.1 UST system is operated to prevent unauthorized release <br /> 10 CCR 2632 c)(2) UST monitoring system is present MI <br /> 11 CCR 2630(d) UST system monitoring equipment is properly located to detect a leak M] <br /> 12 HSC 25291 b UST system monitoring equipment is o erational M2 <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping&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 V^ �/ <br /> 17 HSC 25291 Line leak detectors are installed M1 <br /> 18 CCR 2635(b)(1) Spill container M2 <br /> 19 CCR 2635(b)(2) Overfill prevention system M2 <br /> 20 CCR 2636(a) Conventional suction pipingg shall have continuous monitoring&20 containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases (Mi) <br /> 23 CCR 2715 Designated Operator: a Statement from UST owner; (c-e)Monthly inspection;(f)Employee training <br /> 24 CCR 2638 a Annual monitorin certification <br /> 25 CCR 2638(a) Annual line leak detector test (M] <br /> 26 HSC 25284.2 Annualspill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test M 1 <br /> 28 CCR 2661 (f) Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643 e Biennial tightness test of gravity pipingre-Janus 1, 1984 <br /> 30 'CCR 2643 d. Triennial line test for conventional suctionpipingpre-Jams 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 /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other. <br /> EHD INSPECTOR: PHONE: LIC <br /> Sem1 system: <br /> J Serves 220 people/day <br /> RECEIVED BY: TITLE: 7 Receives other than sanitary waste <br /> /)� Other disposal methods: <br /> �\ wells/French Drains <br /> 14� <br /> END 23-02-002 <br />