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DATE "J BGG <br /> SAN JOAQUIN COUNTY PR# <br /> )VIRONMENTAL HEALTH DEPAINT PAGE <br /> :004 E.Weber Ave.,Third Floor, Stockton, C 5202 <br /> (209)468-3420 <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility Name &n �rfY—vyr)n �n Facility Address a�3) �• I�tQY t �oSQ <br /> FaciltyContact N i t k Ds tTitle `z • V . P Phone# a • $3 <br /> UST# I Product D(LSe-( UST# 2•Product V fS2l UST#_Product UST#_Product <br /> Overfill Prevention: D AudibleNisual "echanical Monitoring Panel: V\Lo V'— <br /> Piping System: ❑Gravity 'Wressbre ❑ Suction Violations: nor ❑ Major <br /> Automatic Pum Shut Down Satisfies CCR 2636 El No Dispenser Pan: es ❑ No <br /> INSPECTION TYPE: outine ❑Monitoring Certification OComplaint ❑Install ❑Removal ❑Repair/Upgrade <br /> COMPANY NAME: TECHNICIAN NAME: PHONE: <br /> VIOLATION(S) <br /> The above facility is not in compliance with the following section(s) of Health & Safety Cade (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(0(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=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 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 /> 7 HSC 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 US- <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: 14 co <br /> RECEIVED BY: 'TITLE: <br /> UNMJ W ST/INSP(rev M4/02) <br />