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0 SAN JOAQUIN COUNTY <br /> ENV[RONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street,Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sigov.org/ehd <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility name: <br /> Designated <br /> O(d 4 6a�oL1�� Insp cion Date: <br /> fps vv io 6j2��� <br /> Facility address: UST# , <br /> Product <br /> Facility Contact: Tide: Phone:— <br /> M!r <br /> Monitoring Panel: � Piping system: Overfill prevention: <br /> y V✓ ressurized D Suction D Gravity echanical D Audible/visual <br /> Inspection type: Violations: <br /> Routine %4onitoring Certification D Installation D Other: D MI-RDetmt D M2-RPrev D M-3 Both <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section V=Violation; RV-Repeat Violation V <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR2637 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 6 Monitoring Program(Monitoring&Response Plan)is current and approved by the local agency. <br /> 6 CCR 2712 i Monitoring Ian is onsite. <br /> 7 CCR 2712 b Maintenance&monitorin records MI <br /> 8 CCR 2643 d Daily monitoring of suction piping(pm-january, 1, 1984) <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoringsystem is resent (MI) <br /> I 1 CCR 2630 d UST system monitoring equipment is properly located to detect a leak MI <br /> 12 HSC 25291 b UST system monitoring equipment isoperational M2) <br /> 13 CCR 2636 I Continuous monitoring system for underground piping&UDC is present Ml <br /> 14 CCR 2631 a Primary containment is roduct ti ht <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in secondary piping flow to a collection sum <br /> 17 HSC 25291 Line leak detectors are installed M 1) <br /> 18 CCR 2635(b)(1) Spill container (M2) <br /> 19 CCR 2635(b)(2) Overfill reventionsystem M2) <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&z-containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR2650 Recording/reportingof unauthorized releases MI <br /> 23 CCR 2715 DesignatedOperator: a)Statement from UST owner; (c-e)Month!y inspection: t)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 Repair for tank/Ei2ing has had tightness test (M2) <br /> 29 CCR 2643 a Biennial tightness test of gravity pipingre-Janua 1, 1984 <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping(pre-January1, 1984) (M I) <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 25298b) 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 Other: <br /> EHD INSPECTOR: P ONE:ZaUIC stem: <br /> S >20 people/day <br /> RECEIVED TITLE: -Receives than sanitary waste <br /> Other disposal methods. <br /> Dry wells/French Drain <br /> EHD 23-02-002 REV 05/07 <br />