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PUBLIC HEALTH SERVICES SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E. Weber Ave., Third Floor, Stockton, CA 95202 <br /> (209) 468-3420 <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility Name t�, S6 CSR, 261i: <br /> DI11Sf <br /> Facility Address ' 1 <br />` Facilty Contact Titl6/ Phone No. <br /> Program ID# Number ofUST(s) <br /> UST# / Product / PC L � a Mechanical ( c1 <br /> Overfill Prevention: Audib e and Visual <br /> Piping system: Gravity Pressure VSuction <br /> Monitoring system �� y �' � e r6 ' k' l� � bg <br /> Automatic pump shutdown satisfies CM2636 (g) : Yes No <br /> VIOLATION(S) <br /> The above facility is not in compliance with the following section(s) of Health & Safety Code <br /> (HSC) and/or California Code of Regulations (CCR) : <br /> 1 HSC 25284 Permit to operate <br /> 2_HSC 25292 .3 Upgrade compliance certificate/sticker <br /> 3 CCR 2711 (b) & (c) Current State Form A & B <br /> 4 HSC 25292 .2 Certification of financial responsibility and letter from chief financial <br /> officer <br /> 5_CCR 2630 (d) Continuous monitoring system for UST system <br /> 6_ CCR 2636 (c)( 1) All releases in secondary piping flow to a collection sump <br /> 7 CCR 2636 (a) Secondary containment for piping is waterproof <br /> 8 CCR 2636 (f)(2) . Automatic line leak detector(s) <br /> 9 CCR 2636 (f)(1 ) Continuous monitoring system for underground piping <br /> 10CCR 2632 (c)(2) Continuous monitoring system for UST <br /> 11 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 12,X, CCR 2636 (f)( 1 ) Continuous monitoring system for dispenser system <br /> 13 � ,CCR 2635 (b)(1) Spill container <br /> 14 CCR 2635 (b)(2) Overfill prevention system <br /> 15 CCR 2631 (a) Primary containment is product-tight <br /> 16�HSC 25292 . 1 UST system is operated to prevent unauthorized release <br /> 17 CCR 2650 Recording/reporting unauthorized release <br /> 18 CCR 2632 (d) Monitoring and response plan <br /> 19 CCR 2712 (i) Monitoring and response plan is on site <br /> 20 CCR 2712 (b) Maintenance and monitoring records <br /> 21 CCR 2636 (f)(4) Annual line tightness test <br /> 22 x CCR 2630 (d) Annual line leak detector test <br /> 23XCCR 2630 (d) Annual monitoring certification <br /> 24 CCR 2643 (d) Daily monitoring of suction piping that is not continuously <br /> monitored �\ <br /> PHS 260 (8/04/00) 1 of_ <br />