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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3"Floor,Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sigov.orgL <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> Ale. qkyo s 2i 0S <br /> Facility address: �,�/' UST# <br /> ago y — Product <br /> Facility Contact: Title: Phone: <br /> NI itoring Panel•ft> Pi 'ng system: Overfill prevention: <br /> es <br /> ��50 Prsumzed ❑Suction ❑Gravit ❑Mechanical Audible/visual <br /> VIn ection type: Violations: <br /> Routine Monitorin Certification 11 Installation El Other: ❑MI-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC=Calif rmia Health&Safety Code;CCR=Califomia Code of Regulations V R V=Violation;RV=Re eat Violation V <br /> I HSC 25284 Permit to operate <br /> 2 CCR 2637 Secondary containment test Performed <br /> 3 CCR 2711 6 & 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 Monitoring&response plan is current and filed with the local agency <br /> 6 CCR 2712'.(i) Monitoring&response plan 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 1 CCR 2630 d UST system monitoring equipment is properly located to detect a leak Ml <br /> 12 HSC 25291 UST system monitoring equipment isoperational M2 <br /> 13 CCR 2636 0(1) Continuous monitoring system for underground piping&UDC is present Ml <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 /> 17 HSC 25291 Line leak detector(s)are installed Ml <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 Recordingtreporting of unauthorized releases (Mill <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly inspection;( 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 (Mill <br /> 28 CCR 2661 R air for tank/piping has had tightness test (M2 <br /> 29 CCR 2643 e Biennial tightness test of gravity pipingre-Jana 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping(pre-January 1, 1984) (Ml <br /> 31 1 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 25298 c Permit to close UST system <br /> 36 HSC 25299.(a)(9) Disabling leak detection devices <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other: <br /> EHD ECTOR: PHONE: UIC <br /> Septic system: <br /> ❑Serves>_20 people/day <br /> RECEIVED B ITLE: ❑Receives other than sanitary waste <br /> Other disposal methods: <br /> ❑Dry wells/French Drains <br /> EHD 23-02-002 <br />