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SAN JOAQUIN COUNTY _NVIRONMENTALHEALTH DEPARTMENT 600 East Main Street, Stockton, California 95202-3029 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.s'gov.org/ehd UNDERGROUND STORAGE TANK (USTI PROGRAM INSPECTION RFPnRT Facility name: 5a,� /� � gyp,,, RW aAkt C. ID�e"siggated Operator: bGV (fJ IAJa�2 p��J Inspection Date" 0'0 f% Facility� ddress: 6T Pac��,z Aft, shalhA UST # - .-Product w - , I ALL —L Facility Contact: nn ,A, t�-'L Tithe,:( XXPhonep^/ ,,rr 0 T/1 �1�K_ 'Y7 2- M ing Monitoring Panel: b Piping system: %Pressurized ❑ Suction ❑ Gravity Overfill prevention: ❑ Mechanical Audible/visua VO In ac tipn;t ourti Monitoring Certification ❑ Installation ❑ Other: Violations: M1-RDetect ❑ M2-RPrev ❑ M-3 Both # Code Section VIOLATION(S) HSC=Califomia Health & Safety Code; CCR=CaI'Ifornia Code of Regulations V R V=Violation; RV=Re eat Violation V 1 HSC 25284 Permit to operate 2 CCR 2637 Secondary containment test performed 3 CCR 2711 b & c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form 4 HSC 25292.2 Certification of financial responsibility and CFO letter 5 CCR 2632 b Monitoring Program(Monitoring & Response Plan is current and approved by the local agency. 6 CCR 2712 i Monitoring Ian is onsite. 7 CCR 2712 b Maintenance & monitoring records M1 8 CCR 2643 d Daily monitoring of suction piping (pre -January, 1, 1984 9 HSC 25292.1 UST system isoperated to prevent unauthorized release 10 11 CCR 2632 (c)(2) CCR 2630 d UST monitoring system is present (M7) UST system monitoring equipment is properly located to detect a leak M1 12 13 HSC 25291 b CCR 2636 1 UST system monitoring equipment isoperational (M1) Continuous monitoring system for underground piping & UDC is present M1 14 1 CCR 2631 a Primary containment is product tight 15 1 HSC 25291 (a)(2) Secondary containment for UST is tight 16 CCR 2636 (c)(1) All releases in secondary pipingflow to a collection sum 17 HSC 25291 Line leak detector(s)are installed M1 18 19 CCR 2635 (b)(1) CCR 2635 (b)(2) Spill container M2) Overfill prevention system 1012 20 CCR 2636 (a) Conventional suction piping shall have continuous monitoring & 20 containment 21 HSC 25291 (e) Water in 2° containment analyzed & propedy disposed of 22 CCR 2650 Recordin2/re2orting of unauthorized releases M1 23 CCR 2715 Designated Operator a Statement from UST owner; jc-e) Monthly inspection; Employee training 24 CCR 2638 a Annual monitorin2 certification 25 CCR 2638 a Annual line leak detector test M1 26 HSC 25284.2 Annuals ill containment testing '27 CCR 2636 4 Annual line tightness test M1 28 29 CCR 2661 CCR 2643 a Repair rtank/piping has had tightness test (M2) Biennial tightness test of gravity piping(pre-January 1, 1984 30 CCR 2643 d Triennial line test for conventional suction piping(pre-January 1, 1984 M1 31 HSC 25292.5 Double walls stem located within 1 000'of public well-ELD 32 CCR 2661 Permit to re air UST system 33 HSC 25286 a Permit to alter monitoring system 34 HSC 25298 b Permit to temporarily close UST system 35 HSC 25298 c Permit to close UST system 36 HSC 25299 (a)(9) 2 Disabling leak detection devices 37 HS 298 a Ille al abandonment of UST system 38 Ot . EHD INSPECTOR: W PHONE: UIC Septic system: T V ❑ Serves 220 people/day TITjJ E: ` ❑ Receives other than sanitary waste Other disposal methods, D Dry wells/French Drains RECEIVED BY: EHD 23-02-002 REV 8/08 v U U