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SAN JOAQUIN COUNTY <br /> NVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3rd Floor, Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> Facility address: UST# t <br /> Product / <br /> Facility Contact: Title: Phone: , <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> 0 Pressurized 0 Suction 0 Gravity 0 Mechanical Audible/visual <br /> Inspection type: Violations: <br /> 0 Routine 0 Monitoring Certification 0 Installation 0 Other: 0 MI-RDetect 0 M2-RPrev 0 M-3 Both <br /> # Code Section <br /> VIOLATIONnme of S) HSC=California Health&Safety Code;CCR=Califia Code RlatiV R V=Violation;RV=Re eat Violation `, <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondarycontainment 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 c 2 D Monitoring&response plan is current and filed with the local agency <br /> 6 CCR 2712 i) Monitoring&response plan is onsite <br /> 7 CCR 2712 b Maintenance&monitoring records Ml <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 (Ml) <br /> 1 I CCR 2630(d) UST system monitoring equipment is properly located to detect a leak M1 <br /> 12 HSC 25291 UST s stem monitoring equipment isoperational M2 <br /> 13 CCR 2636 1) Continuous monitoring system for underground piping&UDC is present Mt) <br /> 14 CCR 2631 a Primary containment is producttight <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 ( Line leak detector(s)are installed (Mi) <br /> 18 CCR 2635 (b)(1) Sill container (142 <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 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reponfing of unauthorized releases MI <br /> 23 CCR 2715 Designated Operator: (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 (MI. <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test Ml <br /> 28 CCR 2661 f) Repair for taX/ptping 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( re-Jana 1, 1984) (MI) <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 HSC 25298(c) Permit to close UST system <br /> 2629 25299(a)(9) Disablingleak detection devices <br /> 37 HSC 25298(a) Illegal abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR: PHONE: UIC t <br /> Sentic system: ' " <br /> -1 Serves Z20 people/day <br /> RECEIVED BY: TITLE: D Receives other than sanitary waste <br /> Other disposal methods: <br /> -]Dry wells/French Drains <br /> F.HD 23-02-002 <br />