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SAN JOAQUIN COUNTY <br /> NVIRONMENTAL HEALTH DEPARTMENT <br /> 304 Ea Weber Avenue, 3`d Floor, Stockton,CA 95202-2708 <br /> G <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.s' ov.or ehd <br /> Facility name: UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Designated Operator: inspection Date: <br /> t S UN R I c ✓i�L1r t R- <br /> Facilityaddress: CAL MO—%��ddress: �^ <br /> UST# A rU � t�7 <br /> Facility Contact: Title: Phone; Product - -M �� ; <br /> Monitoring Panel: Piping system: <br /> N 1-5-1 Overfill prevention: <br /> Q Pressurized uction Gravity echanical ❑Audible/visual <br /> Inspection type: <br /> Routine <br /> solations: <br /> Monitoring Certification C Installation ❑Other: <br /> I]MC-RDetect ❑M2-RI'rev (]M-3 Bath <br /> # Code Section VIOLATION(S) HSC=California Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> I HSC 25284 Permit <br /> V-Violation;RV=Re eat Violation V <br /> to o crate <br /> 2 CCR 2637 Second containment test erformed <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 res2onsibility and CFO letter <br /> 5 CCR 2632 c 2 D Monitorin &response plan is current and filed with the local alyen-1111 <br /> 6 CCR 2712 i) Monitorin &--sponse plan is onsite <br /> 7 CCR 2712(b) Maintenance&monitoring records <br /> 8 CCR 2643 d) Daily monitoring of suction pipin ( re-Jana , 1, 1984 Mi <br /> 9 HSG 25292.1 UST system is operated to 2revcnt unauthorized release <br /> 10 CCR 2632 c 2 UST monitoring system is present <br /> 1 1 CCR 2630(d) UST system monitorin equipment is ro erl located to detect a leak M1 <br /> 12 HSC 25291 b UST system monitorin a ui ment isoperational Mi <br /> 13 CCR 2636 f) 1 Continuous monitorings stem for under round i in &UDC is present M2 <br /> 14 CCR 2637 a} Primer containment is product tight M1) <br /> 15 HSC 25291 (a (2) S'."—f—,containment for UST is tight <br /> 16 CCR 2636 c (1) All releases in seconder i in flow to a collection sum <br /> 17 HSC 25291 if, Line leak detectors are installed <br /> 18 CCR 2635(b (1) S ill container (Mi) <br /> 19 CCR 2635(b(2 Overfill revention s stem {M2) <br /> 20 CCR 2636 a (612) <br /> ( ) Conventional suetion piping shall have continuous monitorin &2°containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Record'n Ire ortin of unauthorized releases <br /> 23 CCR 2715 Desi Hated Operator: a)Statement from UST owner; (c-e Monthlyinspection;(f)Employee trainin (M1 <br /> 24 CCR 2638 a Annual monitorin certification �` <br /> 25 CCR 2638(a) Annual line leak detector test <br /> 26 HSC 25284.2 Annual s i11 containment testingM1) <br /> 27 CCR 2636 4 Annual line tightness test <br /> 2$ CCR 2661 ( Re air for tank/ i in has had tightness test M1 <br /> 29 CCR 2643{e Biennial ti htness test of avit piping re-Janua 1, 1984 (M2) <br /> 30 CCR 2643 (d) Triennial line test for conventional suction i in ( re-Jana 1, 1984 <br /> 31 HSC 25292.5 Double wall s stem located within 1000'of public well-ELD (611) <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286 1-1 Permit to alter monitorin s stem <br /> 34 HSC 25298 Permit to 1--porarily temporarilyclose UST s stem <br /> 35 HSC 25298 c Permit to close UST system <br /> -36 HSC 25299 a(9) Disabb leak detection devices <br /> 37 HSC 25298 a) Illegal abandonment of UST s stem <br /> 38 Other: <br /> EHD INSPECTOR; TPHONE: <br /> LL-Ltr� `l �y t1C <br /> Iw1 l�g-3 L� Senticsystem <br /> RECVED BY: Serves>_20 people/day <br /> TITLE: C Receives other than sanitary waste <br /> Other disposa]methods• <br /> Dry wells/French Drains <br /> EHD 23-02-002 <br />