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OEM 1W P <br /> SAN JOAQUIN COUNTY — <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,Califomia 95202-3029 <br /> Telephone: (209)468-3420 Fax:(209)468-3433 Web:wil clov.oro/ehd <br /> UNDERGROUND STORAGE TANK US PROGRAM INSPECTION REPORT <br /> Designated 4r. Inspection <br /> Facility name: -- Date: <br /> r. <br /> n Facility address: <br /> Facility Contact: Title: Phone: <br /> Overfill prevention: <br /> Monitoring Panel Piping system: <br /> Ur Pressurized ❑Suction D Gravity1 Mechanical ❑Audible/visual <br /> Violations: <br /> Inspection type: <br /> ;OM1-RDetecl ❑M2-RPrev ❑M-3 Both <br /> 0 Routine f Nlon3orin Certification ❑Installation ❑Other V R <br /> # Code Section VIOLATION($) HSC�alifomia Health&Safety Code;GCR=California Code of Regulations V <br /> V=Violation;RV=Re at Violation <br /> 1 HSC 25264 Permit to operate <br /> 2 CCR 2637 Seconds containment test performed <br /> 3 CCR 2711 b & c Current Unified Program Consolidated Fonns on file with EHD Facili and tank form <br /> 4 HSC 25292.2 Certification of financial re onsibil' and CFO letter <br /> 5 CCR 2632 MonitoringPr ram Monitbrin &Res rise Pian is current and a roved b the local a en <br /> 6 CCR 2712 i Moncton lan is onsite. M1 <br /> 7 CCR 2712 b Maintenance&monitoring records <br /> 8 CCR 2643 d Dail monitoringof suction i in re.lanua , 1, 1984 <br /> 9 HSC 25292.1 UST system is operated to <br /> re <br /> unauthorized release M7 <br /> 10 CCR 2632 c 2 UST monitorin s stem is resent ::# <br /> M1 <br /> 11 CCR 2630 UST system monitorin equipment is ro rt located to detect a leak (Mill <br /> 12 HSC 25291 UST s tem monitorin e i ment iso erationalM1 <br /> 13 CCR 2636 1 Continuous monitorings stem for unde round i in &UDC is resent <br /> 14 CCR 2631 a Prima containment is product fight <br /> 15 HSC 25291 a 2 Seconda containment for UST is ti ht <br /> 16 CCR 2636 C 1 All releases in seconds i ing flow to a collection sump (M1 <br /> 17 HSC 25291 Line leak detectors are installed M2) <br /> 18 CCR 2635 b 1 Spill container M2 <br /> 19 CCR 2635 b 2 .Overfill revels stem <br /> 20 CCR 2636(a) Conventional suction Dipinn shall have continuous monitorin &2°containment <br /> 21 HSC 25291 (e) Water in 2'containment analyzed 8,properly disposed of M1 <br /> 22 CCR 2650 Recordingtraporting of unauthorized releases <br /> 23 CCR 2715Desi nate:0 erator. a Statement from UST owner, c-eMontttl inspection; Em to ee trainin <br /> 24 CCR 2638 a Annual monitorin certification M1 <br /> 25 CCR 2638 a Annual line leak detector test <br /> 26 -9§C25284.2 Annuals ill containment testingM1 <br /> 27 CCR 2636 4 Annual line tightness test (M2 <br /> 28 CCR 2661 Repair for tank/piping hashed tightness test <br /> 29 CCR 2643 a Biennial ti htness test of rev' i in re-Janus 7, 1984 M1 <br /> 30 CCR 2643 d Triennial line test for conventional suction ipin re Janus 1, 1984) <br /> 31 HSC 25292.5 Double walls stem located within 1000'of ublic well-ELD <br /> 32 CCR 2661 Permit to repair UST s stem <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 34 HSC 25298 b Permit to tem rari close UST system <br /> 35 HSC 25298 c Permit to dose UST system <br /> 36 HSC 25299 Disabling leak detection devices <br /> (a)(9)(1)(2) <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other: UIC <br /> EHDJNSPECTOR: PHONE ,� <br /> r ( _ c , /C 4 Seasystem: <br /> O'S <br /> erveses 220 people/day <br /> RECENED D Receives other than sanitary waste <br /> B. TITLE:,' Other disposal methods: <br /> Dry wells/French Drains <br /> EHD 23-02-002 REV 8/08 <br />