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17 <br /> SAN JOAQUIN COUNTY <br /> ` ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:m .s' ov.org/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> 1 Ap�'C� SuA)rQK tW-LI pt- Nle 1,3/a 8 <br /> Facility address: (��s�s6 /�y LIST# <br /> 23°i Com! "Aj °I�t ��e �- <br /> Product 1.t <br /> Facility Contact: Title: Phone: <br /> 0W �1q � 3-7i� <br /> Monitoring Panel: Piping system: �� Overfill prevention: <br /> 1�J El Pressurized UCSuction ❑Gravity [i?'lv echanical ❑Audible/visual <br /> Inspection type: Violations: <br /> EiKoutine IXAonitoring Certification ❑Installation El Other: Ll MI-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> V=Violation;RV=Re t Violation V <br /> I HSC 25284 Permit to operate ea <br /> 2 CCR 2637 Secondary containment test perfonned. <br /> 3 CCR 2711 b)& c) Current Unified Program Consolidated Forms on file with EHD(Facility and tank font) <br /> 4 HSC 25292.2 Certification of financial res2onsibility and CFO letter y/ <br /> 5 CCR 2632 b) Monitoring Program(Monitoring&Response Plan)is current and approved by the local agency. <br /> 6 CCR 2712 i) Monitoring 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 isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present (M1) <br /> I l CCR 2630 d UST system monitoring equipment is properILlocated.to detect a leak (M 1 <br /> 12 HSC 25291 b) UST system monitorinE equipment is operational (M2) <br /> 13 CCR 2636(t)(1) Continuous monitoring s stern for underground piping&UDC is present (M1 <br /> 14 CCR 2631 a) Primary containment is eroduct tight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in secondary piping flow to a collection sum <br /> 17 HSC 25291 f Line leak detector(s)are installed M 1) <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 pipinshall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 2"containment analyzed&properly disposed of <br /> 22 CCR 2650 Recordin&eporting ofunauthorized releasee M1) <br /> 23 CCR 2715 Designated Operator: (a)Statement from UST owner; (c-c)Monthly ins ection;(f)Employee training <br /> 24 CCR 2638 a) Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (M 1) <br /> 26 HSC 25284.2 Annual spill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test (Ml) <br /> 28 CCR 2661 (t) Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643 e) Biennial tightness test ofgravity piping re-Janus 1, 1984) <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping(pre-January I, 1984) (M 1) <br /> 31 HSC 25292.5 Double walls stem located within 1000' ofpublic well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286 a) Permit to alter monitoring system <br /> 34 HSC 2.5298(b) Permit to temporarily close UST system <br /> 35 HSC 25298 c) Permit to close UST system <br /> 36 HSC 25299(a)(9) Disabling leak detection devices <br /> 37 HSC 25298 a) Ills al abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> Jf J - _- 7J T Septic system: <br /> Serves>_20 people�day <br /> R IVED BY: TITLE: —Receives other than sanitary waste <br /> Other disposal methods: <br /> Dry wells/French Drains <br /> EHD 23-02-002 REV 05/07 <br />