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`,- SAN JOAQUIN COUNTY Q <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3d Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />IIjNnVlQQQnIjNn cTnuAGF. TANK (IJST) PROGRAM INSPECTION REPORT <br />Facility name: <br />q(;L' .o'-► <br />Designated Operator: <br />Rson1 1�tR�i`1 <br />Inspection Date: <br />5-23-x1 <br />Facility address: <br />G22G CDom' ten! <br />nrsArl/e <br />UST # <br />Product <br />' , •' <br />2 <br />3 <br />Facility Contact: <br />�S (zoti <br />Title: Phone: <br />El %Mkf M6Q• X33 i5�3 <br />(;, <br />'u <br />S <br />,6 <br />/ <br />-7 <br />Moppnitoring Panel: <br />1� � L- Z-J`�%t j <br />Piping system: <br />❑ Pressurized action Cr vity <br />Overfill prevention: <br />Mechanical ❑ Audible/visual <br />Inspection type: <br />Routine AMonitoriniz <br />Certification ❑ Installation ❑ Other: <br />Violations: <br />❑ MI-RDetect ❑ M2-RPrev <br />❑ M-3 Both <br /># <br />Code Section <br />VIOLATION(S) HSC=Califomia Health & Safety Code; CCR=California Code of Regulations <br />V=Violation; RV=Re eat Violation <br />V R <br />V <br />I I <br />HSC 25284 <br />Permit tooperate <br />2 1 <br />CCR 2637 <br />Secondary containment test performed <br />3 1 <br />CCR 2711 & c <br />Current Unified Program Consolidated Forms on file with EHD (Facility and tank form <br />4HSC <br />25292.2 <br />Certification of financial responsibility and CFO letter <br />5 <br />CCR 2632 c (2)(D <br />Monitoring & response plan is current and filed with the local agency <br />6 <br />CCR 2712 i <br />Monitoring & response plan is onsite <br />7 <br />CCR 2712 b <br />Maintenance & monitoring records <br />Ml) <br />8 <br />CCR 2643 d <br />Daily monitoring of suction piping (pre -January, 1, 1984 <br />9 <br />HSC 25292.1 <br />UST system isoperated to prevent unauthorized release <br />10 <br />CCR 2632 (c)(2) <br />UST monitoring system is present <br />Ml <br />11 <br />CCR 2630 d <br />UST system monitoring a ui ment is PToperly located to detect a leak <br />Ml <br />12 <br />HSC 25291 <br />UST system monitoring equipment isoperational <br />M2 <br />13 <br />CCR 2636 (f)(1) <br />Continuous monitoring system for underground piping & UDC is present <br />Ml <br />14 <br />CCR 2631 a <br />Primary containment is product tight <br />15 <br />1 HSC 25291 (a)(2) <br />Secondary containment for UST is tight <br />16 <br />CCR 2636 (c)(I <br />All releases in second piping flow to a collection sum <br />17 <br />HSC 25291 <br />Line leak detector(s) are installed <br />(Mi) <br />18 <br />CCR 2635 1 <br />Spill container <br />M2 <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system <br />(M2) <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring& 20 containment <br />21 <br />HSC 25291 (e) <br />Water in 2° containment analyzed & properly disposed of <br />22 <br />CCR 2650 <br />Recording/reportingof unauthorized releases <br />Ml <br />j ,3 <br />CCR 2715 <br />Designated Operator: a Statement from UST owner; (c -e) Monthly inspection; t) Employee training <br />�. <br />CCR 20383 (a <br />Annual monitoringcertification <br />5 <br />CCR 2638 (a) <br />Annual line leak detector test <br />MI <br />26 <br />HSC 25284.2 <br />Annuals ill containment testing <br />27 <br />CCR 2636 4 <br />Annual line tightness test <br />(MI) <br />28 <br />CCR 2661 <br />Repair for tank/piping has had tightness test <br />M2 <br />29 <br />CCR 2643 a <br />Biennial tightness test of EEEiping(pre-January 1, 1984) <br />30CCR <br />2643 d <br />Triennial line test for conventional suction piRing (pre-January1, 1984 <br />Ml <br />31 <br />1HSC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <br />32 <br />1 CCR 2661 <br />Permit to repair UST system <br />33 <br />HSC 25286 a <br />Permit to alter monitoring system <br />34 <br />HSC 25298 b <br />Permit to temporarily close UST system <br />35 <br />HSC 25298 c <br />Permit to close UST system <br />36 <br />HSC 25299 (a)(9) <br />Disabling leak detection devices <br />37 <br />HSC 25298 a <br />Ille al abandonment of UST system <br />38 <br />Other. <br />EHD INSPECyTOR: <br />( <br />PHONE: <br />RG C 9 L <br />UIC <br />Se� 0 system: <br />Serves >_20 people/day <br />❑ Receives other than sanitary waste <br />Other disposal methods: <br />❑ wells/French Drains <br />Lm;dz:� <br />TITLE: <br />EHD 23-02 <br />1/3/07 <br />