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SAN JOAQUIN COUNTY • DATE_ /asS' <br /> ENVIRONMENTAL HEALTH DEPARTMENT PR# <br /> 304 E. Weber Ave., Third Floor, Stockton,CA 95202 PAGE <br /> (209)468-3420 <br /> -` pUNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility Namei ����^f".�, Facility Address _ Q <br /> FaciltyContact �f�G �p� Title S La.� <br /> UST#_ I product Product Phone # <br /> r ��" UST# UST#_3 Product 6,Z <br /> Overfill Prevention: CAudible/Visual UST#_Product <br /> Piping System: Mechanical Monitoring Panel <br /> ❑Gravity ❑Press re ❑Suction Violations:-AMI-RDet ❑M2-Rpr v D M3-Both <br /> Automatic Pum Shut Down Satisfies CCR 2636 5 : ❑Yes ❑No Desi Hated O erator: - <br /> INSPECTION TYPE: Routine nitoring Certification DCom <br /> COMPANY NAME: plaint pinstall ❑Removal DRepair/Upgrade <br /> TECHNICIAN NAME; rl <br /> ONE: <br /> VIOLATION(S) <br /> The above facility is not in compliance with the following section(s) of Health & Safety Code (HSC)and/or <br /> California Code of Regulations (CCR): <br /> 1 HSC 25284 Permit to operate , <br /> 2_CCR2637 Secondary cont. testing 23--_CCR 2643 (d) Daily monitoring of suction <br /> 3L—CCR 2711(b) & (c) Current State Forms A&Bpiping (pre.-1/1/84) <br /> 4 ✓HSC 25292.2 Certification of financial 24—CCR 2636 (a) Conventional suctionpin i <br /> responsibility& CFO letter shall have continuousP 9 <br /> 6_CCR 2632(d(2) UST monitoring is present(M1) 28 monitoring &2°containment <br /> 6_CCR 2630 (d) UST system monitoring - CCR 2643(e) Biennial tightness test of gravib <br /> equipment is properly located to 26 piping(pre-1/1184) <br /> detect a leak(MI) CCR 2645 (d) Triennial line test for <br /> 7 `✓HSC 25291 (b) UST system monitoring conventional suction(pre <br /> equipment is operational(M1) 27 1/1/84) (M1) <br /> 8_CCR 2636 f 1 g -y CCR 2661 Permit to re y <br /> OO Continuous monitoring System pair UST system <br /> for underground piping& UDC 28—HSC 25286 (a) Permit to alter monitoring <br /> is present(M1) . system <br /> 9—CCR 2636 (c)(1) All releases in secondary —HSC 25298(a) Illegal abandonment of UST <br /> flow to a collection sump 30 29 <br /> 30 system <br /> 10flow25291 (f) Line leak detectors)(M1) HSC 25298 (b) Permit'to temporarily close US- <br /> I 1_HSC 25291(a)(2) Secondary containment forsystem <br /> UST is tight 31 HSC 25298 (c) Permit to close UST system <br /> 12____ <br /> CCR 2635 (b)(1) Spill container(M2) 32 HSC 25292.1 UST. system is operated to <br /> 13_HSC 25284.2 Annual spill container testing 33 CCR 2650 prevent unauthorized release <br /> 14_CCR 2635(b)(2) Overfill prevention system (M2) Recording/reporting <br /> 15 CCR2631 (a) Primary containment is product- unauthorized release,(M1) <br /> tight 34 HSC 25291 (e} Water in 2°cont analyzed and <br /> 16_ /CCR 2632 (c)(2)(0)Monitoring & response plan properly disposed of <br /> 17_CCR 2712(i) Monitoring& response plan is 35 -- CCR 2640 (e) Single wall component within <br /> on site 1000'of Public Well, no ELD <br /> 18--k—/'CCR 2712 b 36 CCR 2635(a)(2)(A) Cathodic protection testing &. <br /> O Maintenance monitoring <br /> records (M1) HSC 25299(a)(9) 60danspection.log (M2) <br /> 19✓CCR 2636 (f)(4) Annual line tightness test 37Disabling leak detect. Devices <br /> 20_%/ 2638 (a) Annual line leak detector test 36—CCR 2715(a) Statement from UST owner <br /> (M1) 39_CCR 2715(c) Monthly inspection by D.0, <br /> 21 _ CCR 2638 (a) Annual monitoring certification 40 CCR 2715 (f) D.O. trained employees <br /> 22 ._CCR 2661 (f) Repair for tank/piping has had 41_ Violation(s)not listed above <br /> ti htness test M2) <br /> EHD INSPECTOR: <br /> NE: <br /> RECEIVED BY: / <br /> v PHOlD 0 <br /> Septic System; TITLE: sanitary <br /> ❑Serves ll/F persons/day ❑Receives other than sanitary aste <br /> Other Disposal Units Identified: ❑Dry wells/French Drains <br /> 11'\Ilnil-III\IISTI LST inenxlinn91500.nOC - - <br />