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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTM,-,�T <br />304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility name: <br />Designated Operator: <br />Inspection Date: <br />T►GC2 PROS <br />69 s7—�he,N <br />3J�ly� <br />Facility address: <br />UST # <br />�G1�1 YOSeV )7C AVC—Nu-6 <br />Product <br />% <br />BSc. <br />Facility Contact: <br />Title: Phone: Lct'(— <br />. <br />P,C& MAN <br />nw n! c --R (PAS 1-N C�� (�0 t) 64'0 -io <br />, <br />Monitoring Panel: <br />Piping system: <br />Overfill prevention: <br />77,S 3 ED <br />pressurized ❑ Suction ❑ Gravity <br />Cy<Iechanical ❑ Audible/visual <br />Inspection type: <br />V_iioolations: <br />Uoutine �onitorin <br />Certification [I Installation El Other: <br />ILMI-RDetect ❑ M2-RPrev ❑ M-3 Both <br />VIOLATION(S) HSC=Califomia Health & Safety Code; CCR=California Code of Regulations V R <br /># <br />Code Section <br />V <br />V=Violation; RV=Re eat Violation <br />1 <br />HSC 25284 <br />Permit tooperate <br />2 <br />CCR 2637 <br />Secondary containment test performed <br />3 <br />CCR 2711 (b) & (c) <br />Current Unified Program Consolidated Forms on file with EHD (Facility and tank form) <br />4 <br />HSC 25292.2 <br />Certification of financial responsibility and CFO letter ✓ <br />5 <br />CCR 2632 (c)(2)(D) <br />Monitoring & response plan is current and filed with the local agency <br />6 <br />CCR 2712 i <br />Monitoring & response plan is onsite ✓ <br />7 <br />CCR 2712 (b) <br />Maintenance & monitoringrecords (Ml) <br />8 <br />CCR 2643 d) <br />Daily monitoring of suction piping (pre -January, 1, 1984 <br />9 <br />HSC 25292.1 <br />UST system isoperated to prevent unauthorized release <br />10 <br />CCR 2632 (c)(2) <br />UST monitoring system is present M1 <br />11 <br />CCR 2630 (d) <br />UST system monitoring equipment is properly located to detect a leak (M1) <br />12 <br />HSC 25291 <br />UST s stem monitoring equipment isoperational (M2 <br />13 <br />CCR 2636 (f)(1) <br />Continuous monitoring system for underground i in &UDC is resent (MI) <br />14 <br />CCR 2631 a) <br />Primary containment is product tight <br />15 <br />HSC 25291 (a)(2) <br />Secondary containment for UST is tight <br />16 <br />CCR 2636 (c)(1) <br />All releases in secondary piping flow to a collection sum <br />17 <br />HSC 25291 (f) <br />Line leak detector(s) are installed (MI) <br />18 <br />CCR 2635 (b)(1) <br />Spill container MZ <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system (M2) <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 2° containment <br />21 <br />HSC 25291 (e) <br />Water in 2° containment analyzed & properly disposed of <br />22 <br />CCR 2650 <br />Recording/reporting of unauthorized releases MI <br />23 <br />CCR 2715 <br />Designated Operator: (a) Statement from UST owner; (c -e) Monthly inspection; Em to ee training <br />24 <br />CCR 2638 (a) <br />Annual monitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test (MI) <br />26 <br />HSC 25284.2 <br />Annuals ill containment testing <br />27 <br />CCR 2636 (f)(4) <br />Annual line tightness test (M1) <br />28 <br />CCR 2661 <br />Repair for tank/pipinghas had tightness test M2 <br />29 <br />CCR 2643 e) <br />Biennial tightness test of gravity piping(re-Januar 1, 1984) <br />30 <br />CCR 2643 d <br />Triennial line test for conventional suction piping (pre-January1, 1984 M1 <br />31 <br />HSC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <br />327 <br />CCR 2661 <br />Permit to repair UST system <br />33 <br />HSC 25286 (a) <br />Permit to alter monitoring system <br />34 <br />HSC 25298 (b) <br />Permit to temporarily close UST system <br />35 <br />HSC 25298 (c) <br />Permit to close UST system <br />36 <br />HSC 25299 (a)(9) <br />Disabling leak detection devices <br />37 <br />HSC 25298 (a) <br />Illegal abandonment of UST system <br />38 <br />Other: <br />EHD INSPECTOR: <br />PHONE: <br />"/� � � � <br />`f <br />UIC <br />Septic system: <br />N RA D'LA <br />J <br />❑ Serves >_20 people/day <br />❑ Receives other than sanitary waste <br />RECEIVED BY: <br />TITLE: <br />_ - Com/ / <br />Jr 25A, <br />C�Z- h( <br />Other disposal methods: <br />11D wells/French Drains <br />EHD 23-02 <br />1/3/07 <br />