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DATE -712910-z <br /> SAN JOAQUIN COUNTY PR# <br /> ENVIRONMENTAL HEALTH DEPARTMENT PAGE 1 .r <br /> 304 E.Weber Ave., Third Floor, Stockton, CA 95202 <br /> (209)468-3420 <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> rFacilty <br /> ility Name <br /> 2 W� - '7 Facility Address <br /> ray pf U� Title /1/1AnR�.�—t''L Phone #��� <br /> Contact A#_ Product UST# Product UST#Product UST# Product <br /> Monitoring Panel: <br /> Overfill Prevention: ❑AudibleNisual ❑ Mechanical Violations: )(Minor ❑ Major <br /> Piping System: Li Gravity ❑ Pressure ❑Suction <br /> Automatic Pum Shut Down Satisfies CCR 2636 : ❑Yes[] No Dispenser Pan: ❑Yes E No <br /> INSPECTION TYPE: poutine ❑Monitoring Certification DComplaint ❑Install ❑Removal ©RepairlUpgrade <br /> COMPANY NAME: <br /> TECHNICIAN NAME: PHONE: <br /> VIOLATION(S) <br /> The above facility is not in cgmpliance with the following section(s) of Health & Safety Code (HSC) and or <br /> I California Code of Regulations (CCR): <br /> 1 NSC 25284 Permit to <br /> - 20 CCR 2712 (b) Maintenance & monitoring <br /> operate records <br /> 2 CCR 2637 Secondary cont testing {6 <br /> month/36 month} 21 CCR 2636 (f)(4) Annual line tightness test <br /> 22 CCR 2630 (d) Annual line leak detector test <br /> 3 CCR 2711(b) & (c) Current State Forms A& B 23CCR 2630 (d) Annual monitoring certification <br /> 4 HSC 25292.2 Certification of financial 24 CCR 2643 (d) Daily monitoring of suction <br /> responsibility and letter from piping that is not continuously <br /> chief financial officer monitored <br /> 5 CCR 2630 (d) Continuous monitoring system <br /> � stem 25 CCR 2643 (d) Triennial tightness test of <br /> for UST I suction piping that is not <br /> 6 CCR 2636 (c)(1) All relea4es in secondary piping continuously monitored <br /> flow to alcollection sump <br /> cant 26 CCR 2643 (e) Biennial tightness test of gravity <br /> 7 HSC 25291 (e) Water in secondary (20) piping that is not continuously <br /> 8-HSC 25291 (f) Automatic line leak detector(s) monitored <br /> 9-CCR 2636 (f)(1) Continu6us monitoring system 27 CCR 2662 Upgrade requirements for UST <br /> for underground piping System <br /> 10 CCR 2632 (c)(2) Continu us monitoring system <br /> for UST 28 CCR 2661 Permit to repair UST system <br /> Seconds containment for 29 HSC 25286 (a) Permit to alter monitoring <br /> 11 HSC 25291(a)(2) Secondary system <br /> UST is tight30 HSC 25298 (a) Illegal abandonment of UST <br /> 12 CCR 2636 (f)(1) Continuous monitoring system system <br /> for dispenser system 31 HSC 25298 (b) Permit to temporarily close USI <br /> 13 CCR 2635 (b)(1) Spill container system <br /> 14 CCR 2635 (b)(2) Overfill 'prevention system 32 HSC 25298 (c) Permit to close UST system <br /> 15 CCR 2631 (a) Primary containment is product 33 33 HSC 25291 (e) Water in 20 cont analyzed and <br /> properly disposed of <br /> 16 HSC 25292.1 UST system is operated to 34 CCR 2640(e} Single wall component within <br /> prevent unauthorized release 1 000'of Public Well, no ELD <br /> 17 CCR 2650 Recording/reporting 35 CCR 2635(a)(2)(A)Cathodic protection testing <br /> unauthorized release <br /> 1 g V CR 2632 (d}� Monitoring & response plan 36 H&SC 25299(a)(9}Disabling leak detect. devices <br /> 1 g�CR 2712 (i) Monitoring &response plan is <br /> 37 Violation(s) not listed above <br /> on site <br /> :EHD INSPECTOR: PHONE: <br /> RECEIVED B TITLE: F - PHONE: <br /> UNffIIUUSTIINSP(rev 315M) <br />