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' n <br /> 40 SAN JOAQUIN COUNTY DATE <br /> ENVIRONMENTAL HEALTH DEPARTMENT PAGE / <br /> 304 E.Weber Ave., Third Floor, Stockton, CA 95202 <br /> (209)468-3420 <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility Name 6Gp��Facility Address 9Z, Z 3 ,Ula I y gc� <br /> Facilty Contact Da 15 Title A&*u, Phone it /04' 15 Lf <br /> r% Coo tz,cc. � �C,poa <br /> UST#� Product '�v1•M UST#�2Product M:J UST#aProduct UL- UST#_ <br /> �— J&Jl s'(sss Lr>Zaaa ''-Mace 6 ,�. e CPT r(.ec <br /> Overfill Prevention: ❑Audible/Visual i&Kechanical Monitoring Panel: <br /> Piping System: ❑Gravity 1J Pfessure ❑Suction Violations: ❑ Minor ❑ Major <br /> Automatic Pump Shut Do n Satisfies CCR 2636 ❑Yes❑No Dispenser Pan: Ids ❑ No <br /> INSPECTION TYPE: outine onitoring Certification DComplaint ❑Install ❑Removal []Repair/Upgrade <br /> COMPANY NAME" r J. TECHNICIAN NAME: PHONE: 'J <br /> VIOLATION(S) 0 U $� I D N <br /> The above facility is not in compliance with the following section(s) of Health & Safety Code (HSC) and/or <br /> California Code of Regulations (CCR): <br /> 1 HSC 25284 Permit to operate 20 CCR 2712 (b) Maintenance & monitoring <br /> 2 CCR 2637 Secondary cont testing (6 records <br /> month/36 month) 21 CCR 2636(f)(4) Annual line tightness test <br /> 3 CCR 2711(b)& (c) Current State Forms A& B 22 CCR 2630(d) Annual line leak detector test <br /> 4 HSC 25292.2 Certification of financial 23 CCR 2630(d) Annual monitoring certification <br /> responsibility and letter from 24 CCR 2643 (d) Daily monitoring of suction <br /> chief financial officer piping that is not continuously <br /> 5 CCR 2630 (d) Continuous monitoring system monitored <br /> for UST system 25 CCR 2636(a) Conventional suction piping <br /> 6 CCR 2636 (c)(1) All releases in secondary piping shall have continuous <br /> flow to a collection sump monitoring &20 containment <br /> 7 HSC 25291 (e) Water in secondary(20)cont 26 CCR 2643 (e) Biennial tightness test of gravity <br /> 8 HSC 25291 (f) Automatic line leak detector(s) piping that is not continuously <br /> 9 CCR 2636 (f)(1) Continuous monitoring system monitored <br /> for underground piping 27 CCR 2662 Upgrade requirements for UST <br /> 10_CCR 2632 (c)(2) Continuous monitoring system system <br /> for UST 28 CCR 2661 Permit to repair UST system <br /> 11 HSC 25291(a)(2) Secondary containment for 29HSC 25286 (a) Permit to alter monitoring <br /> UST is tight system <br /> 12 CCR 2636 (f)(1) Continuous monitoring system 30 HSC 25298 (a) Illegal abandonment of UST <br /> for dispenser system system <br /> 13 CCR 2635 (b)(1) Spill container 31HSC 25298 (b) Permit to temporarily close UST <br /> 14 CCR 2635 (b)(2) Overfill prevention system • system <br /> 15 CCR 2631 (a) Primary containment is product- 32 HSC 25298 (c) Permit to close UST system <br /> tight 33 HSC 25291 (e) Water in 20 cont analyzed and <br /> 16 HSC 25292.1 UST system is operated to properly disposed of <br /> prevent unauthorized release 34—CCR 2640 (e) Single wall component within <br /> 17 CCR 2650 Recording/reporting 1 000'of Public Well, no ELD <br /> unauthorized release 35 CCR 2635(a)(2)(A)Cathodic protection testing <br /> 18_ZCCR 2632 (d) Monitoring & response plan 36 H&SC 25299(a)(9)Disabling leak detect. devices ? <br /> 19 CCR 2712 (i) Monitoring & response plan is 37�iZ Violation(s) not listed above <br /> on site <br /> EHD INSPECTOR: PHONE: <br /> RECEIVED BY: TITLE: <br /> UNITIIVUSTANSP(rev 724/0112) <br /> Pub.Health-Envirl Health 1b6(2/96) ORIGINAL <br />