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• DATE /o l(o -02- <br /> SAN <br /> 0ZSAN JOAQUIN COUNTY • PR# <br /> ENVIRONMENTAL HEALTH DEPARTMENT PAGE <br /> 304 E.Weber Ave., Third Floor, Stockton, CA 95202 V <br /> (209)468-3420 <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> 3`4 W. *5�rwii� M1an <br /> rFacilityNamaPbcility Address Phoneilty Contact Ikl rnfi TitleT# Product _ UST#5 ProductM_UST#(0 Productr�ft�nAUST#_ProductMonitoring Panel'i - a6d <br /> erfill Prevention: ❑AudibleNisual Cr IGtechanical Violations: Minor ❑Major <br /> Piping System: D Gravity &Pressure D Suction // <br /> Automatic Pum Shut Down Satisfies CCR 2636 : D Yes @'No Dis enser Pan: D Yes WNo RrdWo <br /> INSPECTION TYPE: FRoutine OMonitoring Certification OComplaint ❑Install ORemoval ORepair/Upgrade <br /> COMPANY NAME: <br /> TECHNICIAN NAME' PHONE: <br /> VIOLATION(S) <br /> The above facility is not in complianc <br /> California ihe following <br /> Regulations (CCR): &Safety Code (HSC) and/or <br /> 1 HSC 25284 Permit to operate 20_CCR 2712 (b) Maintenance & monitoring <br /> Secorecords <br /> 2 CCR 2637 monthnry/3cont testing (6 21 CCR 2636 (f)(4) Annual line tightness test <br /> 22 CCR 2630 (d) Annual line leak detector test <br /> 3 CCR 2711(b) & (c) Current State Forms A& B <br /> �S/ HSC 25292.2 Certification of financial 23 CCR 2630 (d) Annual monitoring certification <br /> 4 <br /> torrcr �s(w responsibility and letter from 24 CCR 2643 (d) Daily monitoring of suction <br /> piping that is not continuously <br /> 0'r chief financial officer monitored <br /> 5 CCR 2630 (d) Continuous monitoring system 25 CCR 2636 (a) Conventional suction piping <br /> for UST system shall have continuous <br /> g CCR 2636 (c)(1) All releases in secondary piping monitoring &20 containment <br /> flow to a collection sump <br /> 7 ✓ HSC 25291 (e) Water in secondary(20)cont 26—CCR 2643"(e) Biennial tightness test of <br /> piping that is not continuously <br /> g HSC 25291 (f) Automatic line leak detector(s) monitored <br /> 9—CCR 2636 (f)(1) Continuous monitoring system rade requirements for UST <br /> for underground piping 27_CCR 2662 UP9 9 <br /> system <br /> 10 `—'CCR 2632 (c)(2) Continuous monitoring system 28 v CCR 2661 Permit to repair UST system <br /> for UST <br /> 11_HSC 25291(a)(2) Secondary containment for 29—HSC 25286 (a) syseimto alter monitoring <br /> UST is tight <br /> 12 CCR 2636 (f)(1) Continuous monitoring system 30—HSC 25298 (a) Isjegaal abandonment of UST <br /> for dispenser system <br /> 31 HSC 25298 (b) Permit to temporarily <br /> 13 CCR 2635 (b)(1) Spill container close U <br /> 14_CCR 2635 (b)(2) Overfill prevention system system <br /> 15 CCR 2631 (a) Primary containment is product- 8 <br /> 33—HSC 25291 (e) WaterPermino2 close cont analyzed and <br /> tight properly disposed of <br /> 16 HSC 25292.1 UST system is operated to Single wall component within <br /> prevent unauthorized release 34_CCR 2640 (e) 1 000'of Public Well, no ELD <br /> 17—CCR 2650 Recording/reporting <br /> unauthorized release 35_CCR 2635(a)(2)(A)Cathodic protection testing <br /> 18 ✓CCR 2632 (d) Monitoring &response plan 36—H&SC 25299(a)(9)Disabling Violation(s)leak detectsted above devices <br /> 19=CCR 2712 (i) Monitoring &response plan is 37_ <br /> on site LL <br /> EHD INSPECTOR: PHONE: �gi37�P <br /> RECEIVED BY: — TITLE: <br /> UNMIWSTnNSP(rev 724/02) <br />