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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.sigov.org/ehd <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> name: Designated Operator: Inspection Date: <br /> Facility N W '^ILVL <br /> �� M /kv� LLC, ei ti <br /> Facility address: (/!/ UST# '3 C.,/ - - <br /> Pro <br /> Facilit Contact' 1 Title: ' / Phone:// eyr j <br /> Monitoring Panel: 1')\ Piping system: Overfill prevention: <br /> A 60Pressurized ❑Suction ❑Gravity echanica L1Audible/visual <br /> Violations: <br /> Inspection type: <br /> outine onitorin Certification ❑Installation ❑Other: I-RDetec[ ❑M2-RPrev [I M-3 Both <br /> VIOLATIONS) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section V=Violation;RV=R eat Violation V <br /> I HSC 25284 Permit too crate <br /> 2 CCR 2637 Second containment test performed <br /> 3 CCR 2711 b)& c Current Unified Program Consolidated Forms on tile with EHD(Facilityand tank form <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 6 MonitoringProgram(Monitoring&Res onse Plan)is current and approved b the local agency. <br /> 6 CCR 2712 i) Monitoring Ian is onsite. <br /> 7 CCR 2712 6 Maintenance&monitoringrecords MI <br /> 8 CCR 2643 d Daily monitoring of suction pipin (pre-January, I, 1984) <br /> 9 1 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 CCR2630 d UST system monitoringequipment is properly located to detect a leak MI <br /> 12 HSC 25291 6 UST system monitoring equipment isoperational (M2 <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping&UDC is resent MI <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 Line leak detector(s) are installed Ml <br /> 18 CCR 2635(b)(1) Sill container (M2) <br /> 19 CCR 2635(b)(2) Overfill Preventionsystem M2 <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&20 containment <br /> 21 1 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 1 CCR 2650 Recording/reporting of unauthorized releases Ml <br /> 23 1 CCR 2715 Designated Operator a Statement from UST owner; (c-e)Monthly inspection; 0 Em to ee training <br /> 24 1 CCR 2638 a Annual monitoring certification <br /> 25 1 CCR 2638 a) Annual line leak detector test MI) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636(t)(4) Annual line tightness test MI) <br /> 28 CCR 2661 Repair for tank/piLing has had tightness test (M2) <br /> 29 CCR 2643 a Biennial tightness test of gravity piping(pre-January I, 1984 <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping( re-JanuaryI, 1984) M 1) <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 1 HSC 25298 b) Permit to temporarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299(a)(9) Disabling leak detection devices <br /> 37 HSC 25298 a) Illegal abandonment of UST system <br /> 38 Other: <br /> END INSP OR: / PHONE: UIC <br /> kiln, Jj�/ L Septic system <br /> Serves>_20 people/day <br /> REC Y: TITLE: -Receives other than sanitary waste <br /> iOther disposal methods: <br /> 1 � ?-/ a -Dry wells/French Drains <br /> z ; /Z 7 677T <br /> EHD 23-02-002 REV 05/07 <br />