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SAN JOAQUIN COUNTY <br />IVIVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3r" Floor, Stockton, CA 95202- 8 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd <br />UNDERGROUND STORAGE TANK (USTI PROGRAM TNCPFCTInN RFPnRT <br />Facility name: <br />V 64 0 I <br />Designated Operator: <br />D0V, W►c�lV4 <br />Inspection Date: <br />3+kl10 <br />Facility address: '1// <br />IV <br />UST # <br />Product <br />C <br />Facility Con act: <br />Q ✓law <br />Title: Phone: <br />/ <br />(q/,niton g Panel: r� <br />1v y <br />Piping system: <br />Pressurized ❑ Suction ❑ Gravity <br />Overfill prevention: <br />❑ Mechanical Audible/visual <br />Inspection type: <br />Routine Monitoring <br />Certification ❑ Installation ❑ Other: <br />Violations: <br />MI-RDetect ❑ M2-RPrev <br />❑ M-3 Both <br /># <br />Code Section <br />VIOLATIONS) HSC=Califomia Health & Safety Code; CCR=Califomia Code of Regulations <br />V=Violation; RV=Re eat Violation <br />V R <br />V <br />1 <br />HSC 25284 <br />Permit tooperate <br />2 <br />CCR 2637 <br />Secondary containment test performed <br />3 <br />CCR 2711 6 & c <br />Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br />4 <br />HSC 25292.2 <br />Certification of financial responsibility and CFO letter <br />5 <br />CCR 2632 c 2 D <br />Monitorin & response plan is current and filed with the local agency <br />6 <br />CCR 2712 (i) <br />Monitoring & response plan is onsite <br />7 <br />CCR 2712 6 <br />Maintenance & monitoring records <br />(Ml) <br />8 <br />CCR 2643,(d). <br />Daily.monitoring ofsuction . piping (pre -January, 1, 1984) <br />9 <br />HSC 25292.1 <br />UST system isoperated to prevent unauthorized release <br />10 <br />CCR 2632 (c)(2) <br />UST monitoring system is present <br />Ml <br />11 <br />CCR 2630 d <br />UST system monitoring equipment is properly located to detect a leak <br />(Mi) <br />12 <br />HSC 25291 <br />UST system monitoring equipment is operational erational <br />M2 <br />13 <br />CCR 2636 1 <br />Continuous monitoring system for underground piping & UDC is present <br />Ml <br />14 <br />ICCR 2631 a) <br />Primary containment lis'. roductti ht <br />15 <br />HSC 25291 a <br />2 <br />Secondary containment for UST is tight <br />16 <br />CCR 26361 (c)(1) <br />All releases in secondary pipingg flow toa collection sum <br />17 <br />HSC 25291 <br />Line leak detectors are installed <br />MI <br />18 <br />CCR 2635. (b)(1) <br />Spill container <br />(M2) <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system <br />M2 <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 2° containment <br />21 <br />HSC 25291 (e) <br />Water in 20 containment analyzed & properly disposed of <br />22 <br />CCR 2650 <br />Recordin r orling of unauthorized releases <br />MI <br />23 <br />CCR 2715 <br />Designated O erator: (a) Statement from UST owner, (c- Monthly inspection; (f) Employee ning <br />24 <br />CCR 2638 a <br />Annual monitoring certification <br />-V11 <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test <br />(M1) <br />26 <br />HSC 25284.2 <br />Annuals ill containment testing <br />27 <br />CCR 2636 4 <br />Annual line tightness test <br />Ml <br />28 <br />CCR 2661 f) <br />Repair for tank/piping has had tightness test <br />M2 <br />29 <br />CCR 2643 a <br />Biennial tightness test of gravity pipingre-Janus 1, 1984) <br />30 <br />CCR 2643 d <br />Triennial line test for conventional suction pipingre-Jana 1, 1984) <br />(M1 <br />31 <br />HSC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <br />32 <br />CCR 2661 <br />Permit to repair UST system <br />33 <br />HSC 25286 a <br />Permit to alter monitoring system <br />34 <br />HSC. 25298 <br />Permit totemporarily close UST system <br />35 <br />HSC 25298 c <br />Permit to close UST system <br />36 <br />HSC 25299a) (9. <br />Disablin leak detection devices <br />37 <br />HSC 25298 a <br />I..e al abandonment of UST system <br />38 <br />Other: <br />E <br />IA <br />IN <br />I q <br />ECTOR: <br />III <br />PHONE: <br />i f Septicsys[em <br />i <br />UIC <br />❑Serves>_20 people/day <br />❑ Receives other than sanitary waste <br />Other disposal methods <br />❑ Dry wells/French Drains <br />CEIV D Bt <br />TITLE: <br />W <br />FHD 23-02-002 <br />