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0 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:www.sjgov.org/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date; <br /> a C_...1111W 6/21r)/01 <br /> Facility address: UST# ` <br /> 161 Product I f <br /> Facility Contact: Tittle: 14 <br /> Phone: 7-i: "r �— , <br /> o <br /> DM nitoring Panel: Piping system: Overfill prevention: <br /> TL ressurized ❑Suction ❑Gravity ❑Mechanical ❑Audible/visual <br /> Inspection type: Iviolations: <br /> outine 11 Monitorin Certification ❑Installation ❑Other, l-RDetect ❑M2-RPrcv ❑M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V R V=Violation; RV=Re eat Violation V <br /> I NSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test perfortned <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 b) Monitoring Program(Monitoring&Response Plan)is current and aeprowA 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 (MI) <br /> I I CCR 2630 d) UST system monitoring equipment is properly located to detect a leak fml) <br /> 12 HSC 25291 b) UST system monitoring equipment isoperational (M2) <br /> 13 CCR 2636(f)(1) Continuous monitoring system for underground piping&UDC is present (M1) <br /> 14 CCR 2631 a) Primary containment is product 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 t Line leak detector(s)are installed M1) <br /> 18 CCR 2635(b)(1) Sill container (M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system 1'I2) <br /> 20 CCR 2636(a) Conventional suction pipina shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases M1) <br /> 23 CCR 2715 Designated Operator: (a)Statement from UST owner; (c-e)Monthly inspection:(t)Employee training <br /> 24 CCR 263$ a) Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (M1) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636(t)(4) Annual line tightness test (MI) <br /> 28 CCR 2661 f) Repair for tankipiping has had tightness test (M2) <br /> 29 CCR 2643 e) Biennial tightness test of gravity pipinre-JanuaryI, 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 ternporarily close UST system <br /> 35 HSC 25298 c) Pert-nit to close UST system <br /> 36 HSC 25299(a)(9) Disabling leak detection devices _ <br /> 37 HSC 25298 a) hle al abandonment of UST system <br /> 38 Other. <br /> EHD INS OR: PHONE: UIC <br /> Septic system: <br /> Secs X20 peopt-rday <br /> E I D TTLE: -Receives other than sanitary waste <br /> Other disposal methods: <br /> Dry wells/French nrains <br /> EHD 23-02-002 REV 05107 <br />