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4- <br /> PUBLIC HEALTH SERVICES SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E. Weber Ave., Third Floor, Stockton, CA 95202 <br /> (209) 468-3420 <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility Name011 <br /> r <br /> Facility Address I OD Title Phone No. S�a0 <br /> Facilty Contact Number f UST(s) <br /> Program ID# R a :sI III 000 # _ rLMILgD00 bOt� f5 <br /> UST#/Product – Mechanical_�— <br /> Overfill Prevention: Au dt le and Visual--------,PressureSuction <br /> Piping system: Gravity _ <br /> Monitoring system `^ <br /> Automatic pump shutdown satisfies CCR2636 (g): Yes Nom_ <br /> VIOLATIONS) <br /> The above facility is not in compliance with the following section(s)of Health& Safety Code <br /> (HSC) and/or California Code of Regulations (CCR): <br /> 1_HSC 25284 Permit toperate <br /> certificate/sticker <br /> 2_HSC 25292.3 Upgradeco <br /> 3 CCR 2711(b) &(c) Current State Form A&B <br /> 4�HSC 25292.2 Certification of financial responsibility and letter from chief financial <br /> officer <br /> 5_ZCCR 2630 (d) Continuous monitoring system for UST system <br /> 6 CCR 2636(c)(1) All releases in secondary piping flow to a collection sump <br /> 7 CCR 2636(a) Secondary containment for piping is waterproof <br /> 8 CCR 2636 (f)(2) Automatic line leak detector(s) <br /> 9CCR 2636(f)(1) Continuous monitoring system for underground piping <br /> lO�CCR 2632 (c)(2) Continuous monitoring system for UST <br /> 11 HSC 25291(a)(2) Secondary containment for UST is tight <br /> 12 CCR 2636(f)(1) Continuous monitoring system for dispenser system <br /> 13 CCR 2635 (b)(1) Spill container <br /> 14_CCR 2635 (b)(2) Overfill prevention system <br /> 15_CCR 2631 (a) Primary containment is product-tight <br /> 16—HSC 25292.1 UST system is operated to prevent unauthorized release <br /> 17 CCR 2650 Recording/reporting unauthorized release <br /> 18 v7CCR 2632(d) Monitoring and response plan <br /> 19 ✓CCR 2712 (i) Monitoring and response plan is on site <br /> 20_✓CCR 2712 (b) Maintenance and monitoring records <br /> 21 ✓CCR 2636(f)(4) Annual line tightness test <br /> 22 ✓CCR 2630(d) Annual line leak detector test <br /> 23 ✓CCR 2630(d) Annual monitoring certification <br /> 24_CCR 2643 (d) Daily monitoring of suction piping that is not continuously <br /> monitored <br /> 1 of9_ <br /> PHS 260(8/04/00) "` <br />