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SAN jOAQUIN COUNTY DATE Y/,(//0-1 PRS VIRONMENTAL HEALTH QEPAR`f1T PAGE 7 034E. Weber Ave., Third Floor, Stockton, CA 95202 (209)468-3420 UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT Facility Name o� Facility Address Z 1/00 ��- Facilty Contact I-e-D Title Phone # 0G'9 UST#_�L Product (it UST#Product" � ST# b Product f UST# Product Overfill Prevention: ❑Audible/Visual Li4echanical Monitoring Panel: 'b G►1yatfce Piping System: ❑ Gravity (34:rressure ❑ Suction Violations: 3-Vinor ❑ Major Automatic Pump Shut Down Satisfies CCR 2636 (g): ❑Yes bio Dispenser Pan: R-Yes ❑ No INSPECTION TYPE: outine )Oonitoring Certification []Complaint pinstall ❑Removal ❑Repair/Upgrade � $oo COMPANY NAME: TECHNICIAN NAME: r �4� PHONE: VIOLATION(S) The above facility is not in compliance with the following section(s) of Health & Safety Code (HSC) and/or California Code of Regulations (CCR): 1 HSC 25284 Permit to operate 20 CCR 2712 (b) Maintenance & monitoring 2 CCR 2637 Secondary cont testing (6 records month/36 month) 21--,—/C CR 2636 (f)(4) Annual line tightness test 3 CCR 2711(b) & (c) Current State 'Forms A& B 22 CCR 2630 (d) Annual line leak detector test 4 HSC 25292.2 Certification of financial , 23 CCR 2630 (d) Annual monitoring certification responsibility and letter from 24 CCR 2643 (d) Daily monitoring of suction chief financial officer piping that is not continuously 5 CCR 2630 (d) Continuous monitoring system monitored w for UST system 25 CCR 2636 (a) Conventional suction piping 6 CCR 2636 (c){!1) All releases in secondary piping shall have continuous flow to a collection sump monitoring & 2° containment 7 HSC 25291 (e) Water in secondary(2°) cont 26 CCR 2643 (e) Biennial tightness test of gravit 8 HSC 25291 (f) Automatic line leak detector(s) piping that is not continuously 9 CCR 2635 (f)(1) Continuous monitoring system monitored for underground piping 27 CCR 2662 Upgrade requirements for UST 10 CCR 2632 (c)(2) Continuous monitoring system system for UST 28 CCR 2661 Permit to rep9i, UST system 11 HSC 25291(a)(2) Secondary containment for 29 HSC 25286 (a) Permit to alter monitoring UST is tight system 12- CCR 2636 (f)(1) Continuous monitoring system 30 HSC 25298 (a) Illegal abandonment of UST for dispenser system system 13 CCR 2635 (b)(1) Spill container 31 HSC 25298 (b) Permit to temporarily close US 14 CCR 2635 (b)(2) Overfill prevention system system 15 CCR 2631 (a) Primary containment is product- 32 HSC 25298 (c) Permit to close UST system tight 33 HSC 25291 (e) Water in 20 cont analyzed and 16_J!!"*"HSC 25292.1 UST system is operated to properly disposed of prevent unauthorized release 34 CCR 2640 (e) Single wall component within 17 CCR 2650 Recording/reporting 1000' of Public Well, no ELD unauthorized release 35 CCR 2635(a)(2)(A)Cathodic protection testing 18 CCR 2632 (d) Monitoring & response plan 36 H&SC 25299(x)(9)Disabling leak detect. devices 19 CCR 2712 (i) Monitoring & response plan is 37 Violation(s) not listed above on site EHD INSPECTOR: �'E/+�S PHONE: RECEIVED BY: TITLE: /v y t o- UNJT11 W STIINSP(rev 724/02)