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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.sjeov.ore/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> fl b,-t E , Slob VG b� Seruf � a P i�� �� u- /2 fa(o-7 <br /> Facility address: UST# <br /> I ��1 I <br /> D✓, ( Sly �' �1--� s 'Product l -' Ur✓� <br /> Facili[ Contact: Title: Phone: <br /> M(I1'be IAC. Emelt (01-1p. 54 . G02 - 705$ <br /> monitoring Pane Piping system: Overfill prevention: <br /> U %Pressurized ❑Suction ❑Gravity Mechanical ❑Audible/visual <br /> Inspection type: Violations: <br /> %Routme VVIonitoring Certification ❑Installation ❑Other: I ❑MI-RDetect ❑M2-RPrev 11 M-3 Bath <br /> VIOLATION(S) HSC—California Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section <br /> V=Violation;RV=Re eat Violation V <br /> I HSC 25284 Permit tooperate <br /> 2 CCR 2637 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 b) 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&monitoring records Ml <br /> 8 CCR 2643 d Daily monitoring of suction piping(pre-January, 1, 1984) <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present (Ml) <br /> I I CCR 2630 d UST s stem monitoring equipment is properly located to detect a leak Ml <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 MI <br /> 14 CCR 2631 a Primary 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 pipingflow to a collection sum <br /> l7 HSC 25291 t Line leak detectors)are installed M1) <br /> 18 CCR 2635(b)(1) Spill container (M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system M2) <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&20 containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of 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 (M1) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4) Annual line ti htness test M1) <br /> 28 CCR 2661 f) Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643 a Biennial tightness test of gravity piping(pre-January I, 1984) <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping(pre-January 1, 1984) Ml) <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 25298 b) Permit to temporarily close UST system <br /> 35 HSC 25298c) Permit to close UST system <br /> 36 HSC 25299 a)9) Disablin leak detection devices <br /> 37 HSC 25298 a) IIIc al abandonment of UST system <br /> 38 Other: <br /> EHD INS CTOR: PHONE: UIC <br /> VO4 septic system: <br /> Serves>_20 people/day <br /> RE EIVED BY: TITL ,Receives other than sanitary waste <br /> •r disposal methods: <br /> -Dry wells/French Drains <br /> EHD 23-02-002 REV 05/07 <br />