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DATE oj U 2- <br /> SAN <br /> SAN JOAQUIN COUNTY PR# <br /> 304E.1WeeberA e?,pThird HEALTH <br /> oor,SDEPon, CA 95202 PAGE 7t 7_ <br /> (209)468-3420 �"�— <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility Narne S6 _ �_Facility AddressZ_CZ0 W, 1,CZ21. Aj,<;!� <br /> Facilty ContactWW r,, SV(l2/.Title ' Phone# g I <br /> UST#k Product_ UST/# 5 P/y6duct 1/S UST#_Product LUST# ProductA <br /> Piping <br /> Prevention: ❑ Gravity <br /> al ❑ echanical • / Monitoring Panel: no 'S '3�v <br /> Piping System: ❑ Gravity ��jj P essure ❑Suction `(/ Violations: Ll�lnor �alor <br /> Automatic Pum Shut own Sati ies CCR 2636 C Yes ❑ No Dispenser Pan: Yes ❑ No <br /> INSPECTION TYPE: gkoutine Monitoring Certification ❑Complaint ❑Install ❑Removal ❑Repair/U grade <br /> COMPANY NAME: TECHNICIAN NAME: PHONE: Adl — /S <br /> VIOLATION(S) <br /> The above facility is not in compliance with the following section(s) of Health & Safety Code (HSC) and/or <br /> California Code of Regulations (CCR): <br /> 1 HSC 25284 Permit to operate 20 CCR 2712 (b) Maintenance &monitoring <br /> 2 CCR 2637 Secondary cont testing (6 records <br /> month/36 month) 21 CCR 2636 (f)(4) Annual line tightness test <br /> 3 CCR 2711(b) & (c) Current State Forms A& B 22 CCR 2630 (d) Annual line leak detector test <br /> 4 V* HSC 25292.2 Certification of financial 23 CCR 2630 (d) Annual monitoring certification <br /> responsibility and letter from 24 CCR 2643 (d) Daily monitoring of suction <br /> chief financial officer piping that is not continuously <br /> 5 V CCR 2630 (d) Continuous monitoring system monitored <br /> for UST system 25 CCR 2636 (a) Conventional suction piping <br /> 6 CCR 2636 (c)(1) All releases in secondary piping shall have continuous <br /> Flow to a collection sump monitoring &20 containment <br /> 7HSC 25291 (e) Water in secondary (20)cont 26 CCR 2643 (e) Biennial tightness test of gravity <br /> 8 HSC 25291 (f) Automatic line leak detector(s) piping that is not continuously <br /> 9 CCR 2636 (f)(1) Continuous monitoring system monitored <br /> for underground piping 27 CCR 2662 Upgrade requirements for UST <br /> 10 CCR 2632 (c)(2) Continuous monitoring system system <br /> for UST 28 CCR 2661 Permit to repair UST system <br /> 11 HSC 25291(a)(2) Secondary containment for 29 HSC 25286 (a) Permit to alter monitoring <br /> UST is tight system <br /> 12 CCR 2636 (f)(1) Continuous monitoring system 30 HSC 25298 (a) Illegal abandonment of UST <br /> for dispenser system system <br /> 13 CCR 2635 (b)(1) Spill container 31 HSC 25298 (b) Permit to temporarily close UST <br /> 14 CCR 2635 (b)(2) Overfill prevention system system <br /> 15 CCR 2631 (a) Primary containment is product- 32 HSC 25298 (c) Permit to close UST system <br /> tight 33 HSC 25291 (e) Water in 20 cont analyzed and <br /> 16 HSC 25292.1 UST system is operated to properly disposed of <br /> prevent unauthorized release 34—CCR 2640 (e) Single wall component within <br /> 17 CCR 2650 Recording/reporting 1000' of Public Well, no ELD <br /> unauthorized release 35 CCR 2635(a)(2)(A)Cathodic protection testing <br /> 18 CCR 2632 (d) Monitoring & response plan 36 H&SC 25299(a)(9)Disabling leak detect. devices <br /> 19 CCR 2712 (i) Monitoring & response plan is 37 Violation(s) not listed above <br /> on site <br /> EHD INSPECTOR: PHONE: <br /> RECEIVED BY: TITLE: <br /> UNITII WST/INSP(rev 724102) <br />