Laserfiche WebLink
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.siQov.or>?/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facilitv name: I Designated Operator: �^ Inspection Date: <br /> Facility address: UST# <br /> r f le.!✓v;f� ✓ T'(?e-�i'Y^ Product <br /> Facility Contact: Title: Phone: <br /> 3a�+- <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> ► c' " C(,Pressurized ❑Suction ❑Gravity rJ Mechanical Audible/visual <br /> Inspection type: Violations: <br /> Routine F-Monitoring Certification i 1 Installation ❑Other: C M l-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=Califomia Health&Safety Code.CCR=Califomia Code of Regulations V R <br /> Code Section V=Violation;RV=Repeat Violation V <br /> I HSC 25284 Permit to operate <br /> 2 CCR 2637 Secondary containment test performed <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 plan is onsite. <br /> 7 CCR 2712(b) Maintenance&monitoring records (M 1) <br /> 8 CCR 2643(d) Daily monitoring of suction piping( re-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 (M 1) <br /> I 1 CCR 2630(d) UST system monitoring equipment is properly located to detect a leak (M1) <br /> 12 HSC 25291 b) UST system monitoring equipment is operational (M2) <br /> 13 CCR 2636 f)(1) Continuous monitoring system for underground piping&UDC is present (M 1) <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 pipingflow to a collection sum <br /> 17 HSC 25291 (f) Line leak detector(s)are installed (M 1) <br /> 18 CCR 2635(b)(1) Sill container (M2) <br /> 19 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 1 CCR 2650 Recording/reporting of unauthorized releases (M 1) <br /> 23 CCR 2715 DesignatedOperator:(a)Statement from UST owner; (c-e)Monthly inspection,(f)Employee training <br /> 24 CCR 2638 a) Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (M 1) <br /> 26 HSC 25284.2 Annual spill containment testing <br /> 27 CCR 2636 f)(4) Annual line tightness test (M 1) <br /> 28 CCR 2661 (f) Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643(e) Biennial tightness test of gravity piping(pre-January 1, 1984) <br /> 30 CCR 2643(d) Triennial line test for conventional suction piping( re-Janus 1, 1984) (M 1) <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 1 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 INS OR:OR: PHONE/: f UIC <br /> Septic system: <br /> —setve5>-20people/day <br /> RECEIVED BY: :i V TITLE: —Receives other than sanitary waste <br /> Other disposal methods:,., <br /> Dry wells/French Drains <br /> EHD 23-02-003 REV 05/07 <br />