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•U�� ! SAN JOAQUIN COUNTY • <br /> ` ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3'd Floor, Stockton, CA 95202-2708 <br /> r ' ! Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Designated Operator: Inspection Date: <br /> Facility name: <br /> tTST# 3 <br /> Facility address: ' <br /> i ' al <br /> I Yl0(� Product <br /> Facility Contact: <br /> Title: Phone: " <br /> Overfill prevention: <br /> Monitoring Panel: Piping system: <br /> U ressurized ❑Suction ❑GravityLV��olations: <br /> echanical ❑Audible/visual <br /> Inspection type: 1-RDetect ❑M2-RPrev M-3 Both <br /> Routine vlmonitorin Certification ❑Installation ❑Other: V R <br /> # Code Section VIOLATIONS) HSC=California Health&Safety Code;CCR=California Code of Regulations V <br /> V=Violation;RV=Re eat Violation <br /> 1 HSC 25284 Permit too erate <br /> 2 CCR 2637 Secondary containment test erformed <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(c 2)D) Monitorin &response plan is current and filed with the local agency <br /> — <br /> 6 CCR 2712 i Monitorin &response plan is onsite (M1) <br /> 7 CCR 2712 Maintenance&monitoring records <br /> 8 CCR 2643 d) Dail monitoring of suction piping(pre-January, 1, 1984 <br /> 9 HSC 25292.1 UST s stem isoperated to prevent unauthorized release Ml <br /> 10 CCR 2632 c 2 UST monitoringii s stem is present (Ml) <br /> 11 CCR 2630 d UST system monitoring <br /> equipment is ro erl located to detect a leak M2 <br /> 12 HSC 25291 UST system mo aitoring a ui ment isoperational (Ml) <br /> 13 CCR 2636(f)(12 Continuous monitorin s stem for underground piping&UDC is resent <br /> 14 CCR 2631 a) Primar containment is product tight <br /> 15 HSC 25291 a 2 Secondary containment for UST is tight <br /> 16 CCR 2636 c 1 All releases in secondary i in flow to a collection sum (MI) <br /> 17 HSC 25291 ( Line leak detector(s)are installed M2 <br /> 18 CCR 2635 1 Spill container (M2) <br /> 19 CCR 2635(b 2 Overfill prevention system <br /> 20 CCR 2636(a) Conventional suction iping shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 2°containment anal zed& ro erl dis osed of (Ml) <br /> 22 CCR 2650 Recordin /re ortina of unauthorized releases <br /> 23 CCR 2715 Desi ated O erator: Statement from UST owner, c-e Monthl ins ection; Em loyee tramin ✓ <br /> 24 CCR 2638 a Annual irnnnitoring certification (M1) v <br /> 25 CCR 2638(a) Annual line leak detector test <br /> 26 HSC 25284.2 Annuals ill containment testin (Ml) <br /> 27 CCR 2636(f)4) Annual line tightness test M2 <br /> 28 CCR 2661 Re air for tank/pipinghas had tightness test <br /> 29 CCR 2643(e) Biennial ti htness test of avit i in ( re-Januar 1, 1984) Ml <br /> 30 CCR 2643 d Triennial line test for conventional suction i in re-January 1, 1984 <br /> 31 HSC 25292.5 Double walls stem located within 1000'ofpublic well-ELD <br /> 32 CCR 2661 Permit to repair UST s stem <br /> 33 HSC 25286(a Permit to alter monitoring system <br /> 34 HSC 25298 b Permit to temporarily close UST s stem <br /> 35 HSC 25298(c) Permit to close UST system <br /> 36 HSC 25299(a)(9) Disablin leak detection devices <br /> 37 HSC 25298(a) Ille al abandonment of UST system <br /> 38 Other: 5�R: <br /> UICEH SPECT R: / ?r! Sentic system: <br /> `�(� J 7 ❑Serves>_20 peo <br /> TITLE: ❑Rece' >_20e <br /> than sanitary waste <br /> RE EIVED BY: �� Ot s osal methods: <br /> ❑Dry wells/French Drains <br /> EHD 23-02 <br /> 1/3/07 <br />