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SAN JOAQUIN COUNTY <br /> E ENVIRONMENTAL 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 n1a^^m//e// Designated perator: inspection <br /> �(�^ 2{C'i' � P/r �� Dat <br /> Facility address: UST# <br /> Ffol) Oroduct <br /> Fa ility Contact: Title: t <br /> it e i 21`Mo�rit ring PaneJ;, Piping syste Overfill prevention:'(` Pressurizd ❑Suction ❑Mechanical Audible/visual <br /> Violations: <br /> Inspection type: `-3 Both <br /> Routine Monitoring Certification ❑Installation ❑Other: ❑M1-RDetect ❑M2-RPrev <br /> V R <br /> # Code Section <br /> VIOLATION(S) HSC=California Health& Safety Code; CCR=California Code of Regulation V <br /> V=Violation; RV=Re eat Violation <br /> 1 HSC 25284 Permit too -rate <br /> 2 CCR 2637 Seconda containment test nprfnrmpd <br /> 3 CCR 2711 b & c Current Unified Program Consolidated Forms on file with Mth <br /> (Facility <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 b MonitoringPro ram Monitorin & Response Plan is currapproved6CCR2712 i Monitorin Ian is onsite.7 CCR 2712 b Maintenance&monitorin records <br /> 8 CCR 2643 d Dail monitorin of suction in 9 HSC 25292.1 UST s stem iso erated to revent unauthorized releaseM1 <br /> 10 CCR 2632 c 2 UST monitoring system is present M1 <br /> 11 CCR 2630 d UST s stem monitorin a ui m ant is properly located to detect a leak M1) <br /> 12 HSC 25291 b UST s stem monitorin a uipment is c erational M1 <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping&UDC is present <br /> 14 CCR 2631 a Prima containment is product tight <br /> 15 HSC 25291 a 2 Seconda containment for UST is tight <br /> 16 CCR 2636 c 1 All releases in secondary pioinaflow to a collection sum M1 <br /> 17 HSC 25291 Line leak detectors are installed M2) <br /> 18 CCR 2635 b 1 S ill container M2 <br /> 19 CCR 2635 b 2 Ove fill revention s stem <br /> 20 CCR 2636(a) Conventional suction i in shall have continuous monitoring&20 containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&property disposed of M7 <br /> 22 CCR 2650 Recordit Ireporting of unauthorized releases <br /> 23 CCR 2715 Desi nated 0 erator: a Statement from UST owner; c-e onthl ins ection; Em to ee trainin <br /> 24 CCR 2638 a Annual monitoring certification M1 <br /> 25 CCR 2638 a I Annual line leak detector test <br /> 26 HSC 25284.2Annualspill containment testin M7 <br /> 27 CCR 2636 4 Annual line tightness test (M2 <br /> 28 CCR 2661 Repair for tank/piping has had tightness test <br /> 29 CCR 2643 a Biennial tightness test of gravily pipingre-Janua 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping ( re-Janua 1, 1984) M7) <br /> 31 HSC 25292.5 Double wall s stem located within 1000' of ublic well-ELD <br /> 32 CCR 2661 Permit to re air UST s stem <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 34 HSC 25298 to Permit to temporarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299 Disabling leak detection devices <br /> a 9 2 <br /> 37 HSC 25298 a Ille al a s onment of UST s s m W M <br /> 38 Other: V <br /> P NE: 1.11CEHD1 PECTOR: p ZA J69 Se h em: <br /> UV `� D Serves_ le/day <br /> TITLE: �- Receives other t anitary waste <br /> RECEIVED Y: Other disposal methods: <br /> C D wells/French Drains <br /> EHD 23-02-002 REV 8108 <br />