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SAN JOAQUIN COUNTY <br /> VIRONMENTAL HEALTH DEPARTMENT ��// <br /> 304 Eas*eber Avenue,3rd Floor,Stockton,CA 95202-2!rJ8 <br /> Telephone.(209)468-3420 Fax:(209)468-3433 Web:www.sj op v.or <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> � 83S r � <br /> Facility address: USTz3 <br /> # , <br /> 70S i, - - - <br /> Product <br /> Facility Contact: Title: Phone: <br /> 652 70 <br /> Monitoring Panel: Pip, g system: Overfill prevention:C/PI o C <br /> 17 Pressurized ❑Suction ❑Gravity11 Mechanical 1`Audible/visual <br /> Ins ton type: / Violations: <br /> oul,ne Monitorin Certification nstallation ❑Other: ❑Ml-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section VIOLATIONS) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> V=Violation;RV=Re eat Violation V <br /> I HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test Performed <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 c 2 D Monitoring&response plan is current and filed with the local agency <br /> 6 CCR 2712 i Monitoring&response plan is onsite <br /> 7 CCR 2712 b Maintenance&monitoring records MI <br /> 8 CCR 2643(d) Daily monitoring of suction piping(pre-January, I, 1984 <br /> 9 HSC 25292.1 UST system isOperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present Ml <br /> I I CCR 2630 d UST system monitoring equipment is properly located to detect a leak Ml <br /> 12 HSC 25291 UST system monitoring equipment isoperational M2 <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping&UDC is present Ml <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 pipingflow to a collection sum <br /> 17 HSC 25291 Line leak detectors are installed Ml <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&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases Ml <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly inspection; f)Employee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test Ml <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test (MI) <br /> 28 CCR 2661 (f) Repair for tank/ i in has had tightness test (M2) <br /> 29 CCR 2643 e Biennial tightness test of gravity piping( re-Janus 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping(pre-January1, 1984 t) <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 Permit to temporarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299(a)(9) Disablingleak detection devices <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other: <br /> E7= PHONE: UIC <br /> �G 3 septic system, <br /> ❑Serves 220 people/day <br /> 40111 ED BY: TITLE: ❑Receives other than sanitary waste <br /> Other disposal methods <br /> ��`t- G'✓"— C wells/French Drains <br /> EHD 23-02-002 <br />