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PUBLIC HEALTH SERVICES SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E. Weber Ave.,Third Floor, Stockton, CA 95202 <br /> (209) 468-3420 <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility Name <br /> a orowtd Fpc1� <br /> Facility Address O Ma 5 <br /> Facilty Contac ( Title /L Phone No.�3 <br /> Program ID# D Number of UST(s) <br /> UST#/Product - •# - L-; <br /> # - <br /> Overfill Prevention: Audi b e and isual~ Mec anical f <br /> Piping system: Gravity Pressure / Suction <br /> �Ct . k SQ.VISOY' <br /> Monitoring system VV"ti' � ' n _LeD <br /> Automatic pump shutdown satisfies CCR2636 (g): Yes No <br /> VIOLATIONS) <br /> The above facility is not in compliance with the following section(s)of Health& Safety Code <br /> (HSC) and/or California Code of Regulations(CCR): <br /> I_HSC 25284 Permit to operate <br /> 2_HSC 25292.3 Upgrade compliance certificate/sticker <br /> 3 CCR 2711(b)&(c) Current State Form A&B <br /> 4�SC 25292.2 Certification of financial responsibility and letter from chief financial <br /> officer <br /> 5 CCR 2630 (d) Continuous monitoring system for UST system <br /> 6 CCR 2636(c)(1) All releases in secondary piping flow to a collection sump <br /> 7 CCR 2636(a) Secondary containment for piping is waterproof <br /> 8 CCR 2636(f)(2) Automatic line leak detector(s) <br /> 9 CCR 2636(f)(1) Continuous monitoring system for underground piping <br /> 10 CCR 2632 (c)(2) Continuous monitoring system for UST <br /> 11_HSC 25291(a)(2) Secondary containment for UST is tight <br /> 12 CCR 2636(f)(1) Continuous monitoring system for dispenser system <br /> 13 CCR 2635 (b)(1) Spill container <br /> 14_CCR 2635 (b)(2) Overfill prevention system <br /> 15 CCR 2631 (a) Primary containment is product-tight <br /> I6_HSC 25292.1 UST system is operated to prevent unauthorized release <br /> 17�CR 2650 Recording/reporting unauthorized release <br /> 18 CR 2632 (d) Monitoring and response plan <br /> 19 CR 2712 (i) Monitoring and response plan is on site <br /> 20CR 2712 (b) Maintenance and monitoring records <br /> 21 -CCR 2636(f)(4) Annual line tightness test <br /> 22�CCR 2630 (d) Annual line leak detector test <br /> 23 �CR 2630 (d) Annual monitoring certification <br /> 24 CCR 2643 (d) Daily monitoring of suction piping that is not continuously <br /> monitored <br /> I of Z- <br /> PHS 260(8/04/00) <br />