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0 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sieov.orP-/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> s K <br /> rforpufta DW m C, CoJRa 5130)sY <br /> Facility address: �^..rr1t�� /n�,^, q^���� � Fy� UST# t <br /> Ctl <br /> i <br /> Facility Contac[: Title: Phone: <br /> S UNDts moo t w 'W q 4S% 64 66 <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> 2 'iZS 3 SU sRPressurized ❑Suction ❑Gravity VNIechanical ❑Audible/visual <br /> fnnsspection type: // Violations: <br /> C7 Routine 114nitorin Certification ❑Installation ❑Other: ❑M I-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=Califomia Code of Regulations V R V=Violation; RV—Repeat Violation V <br /> I HSC 25 84 Permit tooperate <br /> 2 CCR 26:7 Secondary containment test performed <br /> 3 CCR 27 I b)& c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form) <br /> 4 HSC 25 92.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 26 2 b) Monitoring Program(Monitoring&Response Plan)is current and approved by the local agency. <br /> 6 CCR 27 2 i) Monitoring plan is onsite. <br /> 7 CCR 27 2 b) Maintenance&monitoring records Ml <br /> 8 CCR 26 3 d) Daily monitoring of suction piping(pre-January, 1, 1984) <br /> 9 HSC 25 92.1 UST s stem isoperated to prevent unauthorized release <br /> 10 CCR 26 2(c)(2) UST monitoring system is present (Ml) <br /> I I CCR 26 0 d) UST system monitoring equipment is properly located to detect a leak M I <br /> 12 HSC 25 91 b) UST system monitoring equipment isoperational (M2) <br /> 13 CCR 26 6 1) Continuous monitoring system for underground piping&UDC is present Ml <br /> 14 CCR 26 I a Primary containment is product tight <br /> 15 HSC 25 91 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 26 6(c)(1) All releases in secondary pipingflow to a collection sum <br /> 17 HSC 25 91 t Line leak detectors are installed M1 <br /> 18 CCR 26 5(b)(1) Spill container (M2) <br /> 19 CCR 26 5(b)(2) Overfill prevention system (M2) <br /> 20 CCR 26 6(a) Conventional suction piping shall have continuous monitoring&20 containment <br /> 21 HSC 25 91 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 26 0 Recording/reporting of unauthorized releases Ml) <br /> 23 CCR 27 5 Designated Operator Statement from UST owner; (c-c)Monthly inspection; Em to ee training <br /> 24 CCR 26 8 a Annual monitoring certification <br /> 25 CCR 26 8(a) Annual line leak detector test (M 1) <br /> 26 HSC 25 84.2 Annuals ill containment testing <br /> 27 CCR 26 6-(t I Annual line tightness test MI) <br /> 28 CCR 26 1 t Repair for tank/Ri2inE has had fi htness test (M2) <br /> 29 CCR 26 3 e) Biennial tightness test of gravity piping(pre-January 1, 1984) <br /> 30 CCR2 3 d) Triennial line test for conventional suction piping(pre-January1, 1984) M1) <br /> 31 HSC 25 92.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 26 d Permit to repair UST system <br /> 33 HSC 25 86 a) Permit to alter monitoring system <br /> 34 HSC 25 98 b) Permit to temporarily close UST system <br /> 35 HSC 25 98 c) Permit to close UST system <br /> 36 HSC 25 99(a)(9) Disabling leak detection devices <br /> 37 HSC 25 98(a) Ille al abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> • ' p� � � '! q Septic sys[em: <br /> � N 1!i✓l *4f —3 -Serves 220 People/day <br /> It t:D BV TITLE: -Receives other than sanitary waste <br /> Other disposal methods: <br /> Dry wells/French Drains <br /> 4 <br /> 413 23-02-002 REV 05/07 <br />