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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.or /g ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated O erator: Inspection Date: <br /> yy AAA + 'ler n ��J tics 12�c C 9_ <br /> V1 N Wit, r._'1 - l tJr� <br /> Facility address: �`� UST <br /> "Product <br /> Fac'' Contact: Title: Pho 3 <br /> M ing Panel: Pi ing system: l Overfill prevention: <br /> pressurized ❑Suction ❑Gravitv ❑Mechanical udible/visual <br /> Inspection type: Violations: <br /> )VRoutine onitoring Certification ❑Installation ❑Other: ❑MI-RDetect 1QM2-RPrev ❑M 3c,ilr <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations R <br /> # Code Section V <br /> V=Violation;RV=Re eat Violation <br /> I HSC 25284 Permit tooperate <br /> 2 s CCR 2637 Secondary containment test performed 11-8-65 <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(Monitoring&Response Plan)is current and approved by the local agency. <br /> 6 CCR 2712 i) Monitoring Ian is onsite. C)\,-- <br /> 7 CCR 2712 b) Maintenance&monitoring records (NI l <br /> 8 CCR 2643 d) Daily monitoring of suction piping(pre-January, 1, 1984) <br /> 9 1 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> I O CCR 2632(c)(2) UST monitoring system is present M1) <br /> 11 CCR 2630 d UST system monitoring equipment is properly located to detect a leak M 1) <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 M1 <br /> 14 CCR 2631 a) Primary containment is product tight <br /> 15 1 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 t Line leak detector(s) are installed M 1 <br /> 18 CCR 2635(b)(1) Spill container (M2) <br /> 19 n CCR 2635(b)(2) Overfill prevention system M2 <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases -- (M 1 <br /> 23 CCR 2715 Desi nated O erator:(a)Statement from UST owner; <br /> 24 CCR 2638 a Annual monitoring certification -01 <br /> 25 CCR 2638 a) Annual line leak detector test of-" -01 (M1 <br /> 26 o HSC 25284.2 Annuals ill containment testing 9- o -07 <br /> 27 CCR 2636(f)(4) Annual line tightness test MI <br /> 28 CCR 2661 t) Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643 e) Biennial tightness test of gravity pipingre-Janus I, 1984) <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping(pre-January 1, 1984) M1) <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 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 INSPECT PHONE: UIC <br /> Seotic system: <br /> -Serves>20 people/day <br /> RECEIVED BY: TITLE: -Receives other than sanitary waste <br /> Other disposal methods: <br /> ^41e. -Dry we1WFrench Drains <br /> EHD 23-02-002 REV 05/07 <br />