Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> WINIVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, California 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209)468-3433 Web:www.s'gov.org/ehd <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: <br /> Inspect' <br /> Date:�► Z _ <br /> Z _�l <br /> Facil' ddress: ST <br /> PI P4Aetk <br /> 6 'Product <br /> Facility Contact: Title: Phone: <br /> Z ;cT;0 I <br /> Monitoring Panel: Piping system; Overfill prevention: <br /> _nIG Pressurized ❑Suction ❑Gravity Mechanical El Audiblelvisual <br /> Inspection type: Violations: <br /> Routine Monitoring Certification ❑Installation ❑Other: M1-RDetect M2-RPrev M-jBoth <br /> # Code Section VIOLATIONS) HSC=California Health&Safety Code;CCR=California Code of Regulations V=Violation; RV=Re eat Violation <br /> 1 HSC 25284 Permit too crate <br /> 2 CCR 2637 Seconds containment test erformed I Z~fZ B _lZ_ZaCC( <br /> 3 CCR 2711 b & c Current Unified Program Consolidated Forms on file with EHD (Facility and tank form <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter 12-7-2L - . e, t2--j-2-10(i --A <br /> 5 CCR 2632 b Monitoring Pro ram (Monitoring & Response Pian is current and pproved by the local agency. <br /> 6 CCR 2712 i Monitoring !an is onsite. <br /> 7 CCR 2712 b Maintenance& monitoring records ___LM—I) <br /> 8 CCR 2643 d Dail monitorin of suction i in re-Janus 1, 1984 <br /> 9 HSG 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitorings stem is present (M1} <br /> 11 CCR 2630 d UST s stem monitorin a ui ment is properly located to detect a leak M1} <br /> 12 HSC 25291 b UST system monitoring equipment is operational (M1) <br /> 13 CCR 2636 1 Continuous monitorings stem for underground piping&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 pipingflow to a collection sum <br /> 17 HSC 25291 Line leak detectors are installed (M1 <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 pipin2 shall have continuous monitoring &20 containment <br /> 21 HSC 25291 (e) Water in 2©containment anal ed& pmperly disposed of <br /> 22 CCR 2650 Record inglre orti_ng of unauthorized releases M1 <br /> 23 CCR 2715 Designated Operator: a Statement from UST owner; ;0e)Monthly inspection; Employee trainin <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638 a Annual line leak detector test M1 <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual lino tightness test M1 <br /> 28 CCR 2661 Repair for tank/piping has had tightness test (M2 <br /> 29 CCR 2643 a Biennial tightness test of ravi piping re-Janus 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping (pre-January 1, 1984) {M1} <br /> 31 HSC 25292.5 Double walls stem located within 1000°of public well-ELD <br /> 32 CCR 2661Permit to re air UST s stem <br /> 33 HSC 25286 a Permit to alter monitoringsystem <br /> 34 HSC 25298 b Permit to temporarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299 Disabling leak detection devices <br /> a 9 2 <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other: <br /> EHD IHSPE <br /> R. PFtO E: <br /> LfIC <br /> Septic system: <br /> RECEIVED BY- TITI : 11 Serves z20 peoplelday <br /> X ❑Receives other than sanitary waste <br /> Other disposal methods: <br /> ❑Dry wells/French Drains <br /> EHD 23-02-002 REV 8108 <br />