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SAN JOAQUIN COUNTY <br /> �CNVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street,Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax.(209)468-3433 Web:www.s' ov.ore/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> -(K !� Uar '111110 qjklp`-� <br /> Facility adGress: UST# , 2 <br /> 11 Ai • t LN •"' �z 1� Product <br /> Facility Contact: Title: Phone: <br /> MA er— 31"AdI-e-1 OW 1"k, o G6 IYb <br /> Mo '[ ng Pa : Piping system: Overria prevention: <br /> 611 ressurized ❑Suction ❑Ciravity ❑Mechanical Audible/visual <br /> Inspection type: Violations: <br /> 'irRoutine Monitorin Ccmfrcadon ❑installation ❑Other: ❑MI-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section <br /> V=Violation;RV=R eat Violation V <br /> 1 <br /> VHSC 25284 Permit tooperate <br /> 2 CCR 2637 Second containment test performed <br /> 3 CCR 2711 6 & c Current Unified Program Consolidated Forms on file with EHD(Facilityand tank form) <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> CCR 2632 6 MonitoringProgram(Monitoring&Response Plan is current and approved b the local agency. <br /> 6 CCR 2712 i) Monitoring plan is onsite. <br /> 7 CCR 2712 b) Maintenance&monitoring records MI <br /> 8 CCR 2643 d) Daily monitoring of suction piping(pre-Jams , 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 (M l) <br /> I I CCR 2630 d UST s stem monitoring equipment is properly located to detect a leak (MI) <br /> 12 HSC 25291 b) UST system monitoring equipment is operational (M2) <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping&UDC is Present (Ml) <br /> 14 CCR 2631 (a) Primarycontainment 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 pipingflow to a collection sum <br /> 17 HSC 25291 Line leak detecto s)are installed (MI) <br /> 18 CCR 2635(b)(1) Spill container (M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system M2 <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&20 containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&property disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases Ml <br /> 23 CCR 2715 DesignatedOperator: (a)Statement from UST owner; (c-eXonthly ins ectione t) m to ee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638 a) Annual line leak detector test (MI) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test (MI) <br /> 28 CCR 2661 (f) Repair for tank/piping has had tightness test (M2) <br /> 29 1 CCA 2643 e) Biennial tightness test of gravity pipingre-Janus 1, 1984 <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping( re-Janus I, 1984) (MI) <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 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 1 Other: <br /> EHD I SPECTOR: PHONE: UIC <br /> PU&J GerlL zo�i W 8 8 L/ septic system: <br /> Serves>_20 people/day, <br /> RECEIVED BV: TITLE: --Receives other than sanitary waste <br /> Other disposal methods: <br /> wells/French Drains <br /> EHD 23-02-002 REV 05/07 <br />