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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT• <br /> 304 East Weber Avenue, 3`a Floor, Stockton,CA 95202-2708 <br /> Telephone: (209)468-3420 Fax:(209)468-3433 Web:www.sijzov.orp/eh <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facility name:d <br /> Designated Operator: Inspection Date: <br /> Facility address: UST# <br /> �(�, � �, Product f <br /> Fac'ity Contact: Title: Phone: <br /> Monitoring Panel: _ Piping system: Overfill prevention: <br /> TLS essurized ❑Suction ❑Gravi ❑Mechanical ❑Audible/visual <br /> inspection type: ,�, 1 Violations: <br /> , <br /> cEtt.outine Vonitonn Certification ❑Installation ❑Other: ❑MI-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATIONS) HSC=Califomia Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 b & c Current Unified Program Consolidated Fomes on file with EHD(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 CCR2712 i <br /> Monitoring&response plan is onsite <br /> 7 CCR 2712 b Maintenance&monitoring records MI <br /> 8 CCR 2643 d Daily monitoring of suction piping(pre-January, 1, 1984) <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present Ml <br /> 11 CCR 2630 d UST system monitoring equipment is properly located to detect a leak M1 <br /> 12 HSC 25291( UST system monitoring p is operational M2) <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping&UDC is present M 1 <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 acollection sum <br /> 17 HSC 25291 Line leak detectors 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 20 containment analyzed&properly disposed of <br /> 22 CCR 2650. Recordingtreportingof unauthorized releases . (Mill I <br /> 23 CCR 2715 DesignatedOperator:(a)Statement from UST owner; (c-e)Monthly ins ection; m to ee training <br /> 24 CCR 2638 a Annualmonitoringcertification ✓ <br /> 25 CCR 2638(a) Annual line leak detector test Ml <br /> .7 <br /> 26 HSC 25284Annuals ill containment <br /> 27 CCR 2636 4 Annual line tightness test M1 <br /> 28. CCR 2661 Repair for tank/pipinghas had tightness test (M2 <br /> 29 CCR 2643 a Biennial tightness test of gravitypiping re-Jana 1, 1984 <br /> 30 CCR 2543 d Triennial line.test for conventional suction piping(pre-January'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 raril close UST system <br /> nSPECDTR: <br /> c Permit to close UST system <br /> HSC 25299 a 9 Disabling leak detection devices <br /> 8 a Illegal <br /> abandonment of UST system <br /> : PHONE UIC <br /> TITLE: ❑Receive er than sanitary waste <br /> al methods: <br /> (n � - wells/French Drains <br /> F,HD 23-02-002 <br />