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' SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT• <br /> 304 East Weber Avenue,3`d Floor,Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd <br /> UNDERGROUND STORAGE TANK ST PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date- <br /> 0141(al M1 <br /> Facility address: UST# <br /> 71M _ Product ON LL <br /> Facilitv 'ontact: Title: Phone: y <br /> rb >✓ (amu � � � � s- - = . <br /> (Monitoring Pa I: Piping system: Overfill prevention: <br /> // ' ❑Pressurized Suction ❑Gravity Mechanical ❑Audible//visual <br /> Inspection type: Violations: <br /> L Routine Monitoring Certification ❑Installation ❑Other: • Ml-RDetect ❑M2-RPrev M-3 Roth <br /> VIOLATION(S) HSC-California Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section V <br /> V=Violation;RV=Re eat Violation <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondaty containment testper-formed <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 <br /> 5 CCR 2632 c 2 D Monitoring&response plan is current and filed with the local agency <br /> 6 CCR 2712(i) Monitoring&response plan is onsite <br /> 7 CCR 2712 b) Maintenance&monitoringrecords (Ml) <br /> 8 CCR 2643 d Daily monitoring of suction pi2ing(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 resent M 1) <br /> 11 CCR 2630(d) UST system monitoring a ui went is properly located to detect a leak (M 1) <br /> 12 HSC 25291 UST system monitoring equipment is operational M2) <br /> 13 CCR 2636 (l) 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 ti ht <br /> 16 CCR 2636(c)(1) All releases in secondary pipingflow to a collection sum <br /> 17 HSC 25291 Line leak detector(s)are installed (MI) <br /> 18 CCR 2635(b)(1) Spill container (N12) <br /> 19 CCR 2635 b)(2) Overfill prevention system (M2 <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Recordin reporting of unauthorized releases M1 <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-c)Monthly inspection; f)Employee trainin <br /> 24 CCR 263$ a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (MI) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 277 CCR 2636( 4) Annual line tightness test (M 1) <br /> 28 CCR 2661 Repair for tank/piping has had tightness test (N12) <br /> 29 CCR 2643 e Biennial tightness test of gravity piping( re-Januar 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 2661 Permit to repair UST system <br /> 33 HSC 25286 a Permit to alter monitoring system <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(a)(9) Disabling leak detection devices <br /> 37 HSC 25298(a) Illegal abandonment of UST system <br /> 38 Other: <br /> EINSP_CTOR: HON'E: UIC <br /> /t f Septic system: <br /> IrwrU Serves>_20 people/day <br /> RE _ VE Y: TITLE: Receives other than sanitary waste <br /> Other disposal methods: <br /> X r1V l/ Dry wells/French Drains <br /> EHD 23-02-002 <br />