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SAN JOAQUIN COUNTY *4/ <br /> *9VIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street,Stockton,Califomia 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www sieov.orgJehd <br /> UNDERGROUND STORAGE TANK US PROGRAM INSPECTION REPORT <br /> Designated Operator: luspection Date: <br /> Facility name: <br /> t .l U ent, at G5 ti— <br /> I 1 S o-7 <br /> UST# , <br /> Facility address: <br /> 76-7 G YO,,-6c, 44 tfG 'Product <br /> Fecilit Contact: Title: Phone: US <br /> a C5'C06' <br /> Monito 'ng Panel: // Pip' system: Overfill prevention: <br /> (�� 370 surized ❑Suction ❑Gravity aechanical ❑Audible/visual <br /> Violations: <br /> Io eline type: �� //'' <br /> C Routine E3Tlonitorin Certification ❑Installation 11 Other ❑MI-RDetect 2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section V=Violation;RV=R eat Violation V <br /> 1 HSC 25284 Pertnit too erate <br /> 2 CCR 2637 Secondary containment test pertortned <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 jMonitoring&Response Plan is current and apploved by the local a enc . <br /> 6 CCR 2712 i) Monitoring Ian is onsite. <br /> 7 CCR 2712 6 Maintenance&monitoringrecords (MI) <br /> 8 CCR 2643 d Daily monitoring of suction piping(pre-January, I, 1984) <br /> 9 HSC 25292.1 UST system is operated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoringsystem is t (Ml) <br /> 11 CCR 2630 d UST system monitoringequipment is properly located to detect a leak Ml <br /> 12 HSC 25291 UST system monitoring equipment is operational M2) <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping&UDC is plesent 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 piping flow to a collection sum <br /> 17 HSC 25291 Line leak detector(s) are installed Ml <br /> 18 CCR 2635(b)(1) S ill 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 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Recordin&Lrej2ortm&of unauthorized releases Ml <br /> 23 CCR 2715 Desi nated for (a)Statement from UST owner (c-e)Monthly ins ection f)Employee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638 a Annual line leak detector test (Ml) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> CCR 26364 Annual line tightness test Ml <br /> 2 <br /> 28 CCR 2661 Repair for tank/pipiny,has had tightness test M2) <br /> 29 CCR 2643 a Biennial tightness test of gravity pipingre-Jana 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping(pre-January1, 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 6 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 1 HSC 25298 a Illegal abandonment of UST system <br /> 38 1 Other. <br /> RHD INSPECT PHONE: UIC <br /> Septic aystem: <br /> Serves>_20 people/day <br /> RECEIV TITLE: -Receives other than sanitary waste <br /> Other D y well methods: <br /> Drains <br /> EHD 23-02-002 REV 05/07 „,.�, <br />