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f <br /> • SAN JOAQUIN COUNTY <br /> aNVIRONMENTAL HEALTH DEPARTMENT 10 <br /> 304 EWeber Avenue, 3rd Floor, Stockton,CA 95202- 08 <br /> Telephone: (209)468-3420 Fax:(209)468-3433 Web:www.sdRov.org/eh <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facility name!:, Designated Op rator. Inspection Date: <br /> �Vi <br /> Facility address: OST# �t-0) .i IQ I <br /> l Product I 'Q <br /> Facilit Co a I Title: Phone: <br /> Mitoring ane: Piping system: Overfill prevention: <br /> WEressurized ❑Suction ❑Gravity Mechanical ❑Audible/visual <br /> Inspection type: iolations: <br /> Routine Monitoring Certification ❑Installation ❑Other: MI-RDetect U M2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section <br /> V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit tooperate <br /> .2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 6 & c Current Unified Program Consolidated Forms on file with EHD(Facilityand tank form <br /> F4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 c 2 D Monitoring&response Ian is current and filed with the local agency <br /> 6 CCR 2712 i Monitoring&response plan is onsite <br /> 7 CCR 2712 6 Maintenance&monitoring records (Mi) <br /> 8 CCR 2643 d. Dail y 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 (MI) <br /> 11 CCR 2630(d) UST system monitoring equipment is properly located to detect a leak M] <br /> 12 HSC 25291 (b UST system monitoring equipment isoperational M2 <br /> 13 CCR 2636(f)(1) Continuous monitoring system for underground piping&UDC is present M] <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)(l All releases in secondary pipingflow to a collection sum <br /> 17 HSC 25291 f) Line leak detectors are installed Ml <br /> 18 CCR 2635 (b)(1) Sill container M2 <br /> 19 CCR 2635 (b)(2) Overfill prevention system M2 <br /> 20 CCR 2636(a) Conventional suction p piping shall have continuous monitoring&20 containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reportingof unauthorized releases Ml <br /> 23 CCR 2715 Desi nated Operator:(a)Statement from UST owner; (c-e)Month!y inspection;(f)Employee training <br /> 24 CCR 2638 a) Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (MI) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test Ml <br /> 28 CCR 2661' Repair for tank/piping has had tightness test (M2 <br /> 29 CCR 2643 a Biennial tightness test of gravity pipingre-Januar 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping(pre-Jam '1, 1984) (MI) <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 Permit to temporarily close UST system <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 Illegal abandonment of UST system <br /> 38 Other: <br /> E IN ECTOR: C PHONE: / UIC Septic system: <br /> J -Serves>_20 people/day <br /> RECEIV D TITLE: Receives other than sanitary waste <br /> Other disposal methods: <br /> I_:Dry wells/French Drains <br /> F14D 23-02-002 <br />