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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.sigov.org/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> L-Yle— /C*" <br /> Facility address: UST# y <br /> k'55-:5 (an4e ( rCA Product p� <br /> Facility Contact: I Title: Phone: <br /> i Ckl1 hv, l A,,, l t}os-titz-z4s ;" Jam'pi <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> 3Sp ressurized ❑Suction ❑Gravity cchanical ❑Audible/visual <br /> Inspection type: lations: <br /> outine ,-0Qnitoring Certification ❑Installation ❑Other: MI-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section V <br /> V=Violation; RV=Re eat Violation <br /> 1 HSC 25284 Pennit tooperate <br /> 2 CCR 2637 Secondary containment test perfortned <br /> 3 CCR 2711 b)& c) Current Unified Program Consolidated Fonrts on file with EHD(Facility and tank fon-n) <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 b) Monitoring Pro rain(Monitoring&Response Plan)is current and approved by the local agency. <br /> 6 CCR 2712 i) Monitoring Ian is onsite. <br /> 7 CCR 2712 b Maintenance&monitoring records (M 1 <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 (M1) <br /> I I CCR 2630 d) UST system monitoring equipment is properly located to detect a leak (M l) <br /> 12 HSC 25291 b) UST system rnonitonng equipment isoperational (1'12) <br /> 13 CCR 2636(t)(1) Continuous monitoring system for underground piping&UDC is present (MI) <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 t Line leak detector(s)are installed (INI1) <br /> 18 CCR 2635(b)(1) Spill container (1M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system (112) <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 (NI I) <br /> 23 CCR 2715 Designated Operator: (a)Statement from UST owner; (c-e)Monthly inspection;(t) Employee training <br /> 24 1 CCR 2638 a) Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (M l) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test (M t) <br /> 28 CCR 2661 t) Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643 e) Biennial tightness test of gravity piping re-Janus 1, 1984) <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping(pre-January I, 1984) (M 1) <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Pennit to repair UST system <br /> 33 HSC 25286 a) Permit to alter monitorings stem <br /> 34 HSC 25298 b) Permit to temporarily close UST system <br /> 35 HSC 25298 c) Pennit to close UST system <br /> 36 HSC 25299(a)(9) Disabling leak detection devices <br /> 37 HSC 25298 a) I Illegal abandonment of UST system <br /> 38 Other: <br /> EHD INSPECT PHONE: UIC <br /> Q'��Q�/ Septic system: <br /> VV ( lJ -Sen cs>_'_0 peoplr'day <br /> RECEIV t TITLE: - Receives other than sanitary waste <br /> AS <br /> 6-Alt <br /> _, Other disposal methods: <br /> `IAV I 4Dry wells/French mains <br /> EHD 23-02-002 REV 05/07 <br />