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SAN JOAQUIN COUNTY <br />,;NVIRONMENTAL 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 INSPECTIONgo� W'01:11" <br />Facility name: <br />� 00 <br />D�i�g/n�ated Operator: nn'spectio ate: <br />6 1 olJ� f IlY/tn � / <br />Facility address: u <br />( <br />UST # <br />Product <br />n <br />Conta t• Title: Phone: <br />, <br />itoring Panel- <br />P• Ing system: <br />Pressurized ❑ Suction ❑ Gravity` <br />Overfill prevention: <br />❑ Mechanical Audiblelvisual <br />In pection type: <br />Routineonitoring Certification 11Installation ElOther: I <br />Violations: <br />11MI-RDetect ElM2-RPrev Ll M-3 Both <br /># <br />Code Section <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=California Code of Regulations V R <br />V=Violation; RV=Re eat Violation V <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 b) <br />Monitoring Program(Monitoring & Response Plan is current and approved by the local agency. <br />6 <br />CCR 2712 (i) <br />Monitoring plan is onsite. <br />7 <br />CCR 2712 b) <br />Maintenance & monitoring records 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 (Ml) <br />1 I <br />CCR 2630 d) <br />UST system monitoring equipment is properly located to detect a leak M1 <br />12 <br />HSC 25291 b <br />UST s stem monitoring equipment isoperational (M2) <br />13 <br />CCR 2636 (f)(1) <br />Continuous monitoring system for underground piping & UDC is present (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)(I) <br />All releases in secondary pipingflow to a collection sump 7 <br />17 <br />HSC 25291 <br />Line leak detector(s) are installed (MI) <br />18 <br />CCR 2635 (b)(1) <br />Spill container (M2) <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 />1 CCR 2650 <br />Recording/reporting of unauthorized releases Ml <br />23 <br />CCR 2715 <br />Designated Operator: a Statement from UST owner; (c -e) Monthly inspection; f) Employee training <br />24 <br />CCR 2638 a <br />Annual monitoring certification <br />25 <br />CCR 2638 a) <br />Annual line leak detector test (M1 <br />26 <br />HSC 25284.2 <br />Annuals ill containment testing <br />27 <br />CCR 2636 f)(4) <br />Annual line tightness test (MI) <br />28 <br />1 CCR 2661 f) <br />Repair for tank/piping has had tightness test (M2) <br />29 <br />1 CCR 2643 a <br />Biennial tightness test of gravity piping(pre-January 1, 1984 <br />30 <br />CCR 2643 (d) <br />Triennial line test for conventional suction piping (pre-January1, 1984 (Ml) <br />31 <br />HSC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <br />32 <br />CCR 2661 <br />Permit to r air UST system <br />33 <br />HSC 25286 a <br />Permit to alter monitoring system <br />34 <br />HSC 25298 b) <br />Pertnit to temporarily close UST system <br />35 <br />1 HSC 25298 c <br />Permit to close UST system <br />36 <br />HSC 25299 a)(9) <br />leak detection devices <br />37 <br />HSC 25298 a) <br />-Disabling <br />Illegal abandonment of UST system <br />3 <br />Other. <br />A.1N_6PE <br />TIOHONAnA <br />(/ <br />V I (� J �vl K! �/, Senticsystem: UIC <br />❑ Serves >_70 people/day <br />TITLE: ❑Receives other than sanitary waste <br />Other disposal methods: <br />vl A ❑ Dry we11s/French Drains <br />REC V i3 <br />EHD 23-02-002 REV 05/07 <br />