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SAN JOAQUIN COUNTY <br /> ��,, NVIRONMENTAL HEALTH DEPARTMENT <br /> 304 Eagt1'1tVeber Avenue,3rd Floor, Stockton,CA 9520708 <br /> Telephone:(209)468-3420 Far:(209)468-3433 Web:www.sjgov.org/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facilitv name: Designated Operator: Inspection Date: <br /> ���o �[,,q�uti..�tJE �-��� '�.ti--SNIP. . E �`�• Qw��o� <br /> Facility address: /� UST# <br /> 72 W t c ap,t..1T LA r4 Product $1 r <br /> Facility Contact: Title: Phone: <br /> pyebo SuQ v�sotz <br /> M 'toying Panel: IK'-ssurized <br /> g system: Overfill prevention: <br /> 'VL jam ❑Suction ❑Gravity ❑Mechanical Audible/visual <br /> I pect.on type: Violations: <br /> Routine onitorin Certificaiion ❑Installation ❑Other: ❑Ml-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section <br /> V=Violation;RV—Repeat Violation V <br /> 1 HSC 25284 Permit too Crate <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 & c Current Unified Program Consolidated Forms on file with EHD(FacilitX 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&res nse plan is onsite <br /> 7 CCR 2712 b 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 iso crated to prevent unauthorized release <br /> 10 CCR 2632 c)(2) UST monitoring system is present M1) <br /> 1 l CCR 2630(d) UST system monitoring equipment is properly located to detect a leak Ml <br /> 12 HSC 25291 (b) UST system monitoring equipment isoperational M2 <br /> 13 CCR 2636 (1) Continuous monitoring system for under round pi2ing&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 pipiLng.flow to a collection sum <br /> 17 HSC 25291 f) Line leak detector(s)are installed (MI) <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 piping shall have continuous monitoring&20 containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&property 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 traininv <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (MI) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4) Annual line tightness test (MI) <br /> 28 CCR 2661 Repair for tank/piping has had tightness test (M2 <br /> 29 1 CCR 2643 e Biennial tightness test of gravity piping( re-Jams 1, 1984) <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping(pre-January1, 1984) (M1 <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 1 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 1 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> \AJ k4-. -( NCA 68 - bit-( Septic system: <br /> Serves>_20 people/day <br /> REQ'EIVED BY: TITLE: Receives other than sanitary waste <br /> Other disposal methods: <br /> wells/French Drains <br /> FHD 23-02-002 <br />