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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.s'goy.org/ehd <br />UNDERGROUND STORAGE TANK (USTI PROGRAM INSPECTION REPORT <br />Facility name: <br />Designated Operator: <br />/ <br />Ins ction <br />Date: <br />Facility address: <br />4 25 b <br />Facility Contact: Title: Phone: <br />UST # , - <br />.'Product <br />_� QiieyLl <br />. <br />M ' oring Panel; Piping system: <br />L ressurized ❑ Suction ❑ Gravity <br />Inspection type: <br />NbRoutine onitoring Certification ❑ Installation ❑ Other: <br />Overfill prevention: <br />❑ Mechanicaludible/visual <br />Violations: <br />1-RDetect ❑ M2-RPrev ❑ M-3 Both <br /># <br />Code Section <br />VIOLATION(S) HSC=Califomia 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 />4 <br />CCR 2711 b & c <br />HSC 25292.2 <br />Current Unified Proram Consolidated Forms on file with EHD(Facility and tank form x <br />Certification of financial responsibility and CFO letter <br />5 <br />CCR 2632 <br />b <br />Monitoring Program(Monitoring & Response Plan Is current and approved by the local agency. <br />6 <br />CCR 2712 <br />i <br />Monitoring Ian is onsite. <br />7 <br />CCR 2712 b <br />Maintenance & monitoring records M7 <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 />11 <br />CCR 2632 (c)(2) <br />CCR 2630 d <br />UST monitoring system is present M1) <br />UST system m nitoring equipment is Properly located to detect a leak M1 <br />12 <br />13 <br />HSC 25291 b <br />1 CCR 2636 1 <br />UST system monitoring equipment isoperational (M1) <br />Continuous monitoring system for underground piping & UDC is present M1 <br />14 <br />1 CCR 2631 a <br />Primary containment is product tight <br />15 <br />1 HSC 25291 (a)(2) <br />Secondary containment for UST is tight <br />16 <br />1 CCR 2636 (c)(1) <br />All releases in Seconda piping flow to a collection sum <br />17 <br />18 <br />19 <br />1 HSC 25291 <br />CCR 2635 (b)(1) <br />1 CCR 2635 (b)(2) <br />Line leak detectors are installed (M1 <br />Spill container (1012 <br />Overfill Prevention system 11112 <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 20 containment <br />21 <br />HSC 25291 (e) <br />Water in 20 containment analyzed & properly disposed of <br />22 <br />CCR 2650 <br />ReGording/reporting of unauthorized releases M7 <br />23 <br />CCR 2715 <br />Designated Operator. a Statement from UST owner; (c -e) Monthly inspection: 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 4 <br />Annual line tightness test M1 <br />28 <br />29 <br />CCR 2661 <br />CCR 2643 a <br />Repair for tank/pipinq has had tightness test (M2 <br />Biennial tightness test of gravity piping(pre-January 1, 1984 <br />30 <br />31 <br />CCR 2643 d <br />HSC 25292.5 <br />Triennial line test for conventional suction i in(pre-January 1, 1984 (M1 <br />Double walls stem located within 1 000'of public well-ELD <br />32 <br />CCR 2661 <br />Permit to repair UST system <br />33 <br />1 HSC 25286 a <br />Permit to alter monitoring system <br />34 <br />1 HSC 25298 b <br />Permit to temr)orariiy close UST system <br />35 <br />1 HSC 25298 c <br />Permit to close UST system <br />36 <br />HSC 25299 <br />a 9 2 <br />Disabling leak detection devices <br />37 <br />HSC 25298 a <br />Illegal abandonment of UST system <br />38 <br />Other: <br />EHD INS R: <br />PHONE: <br />`-( (� / b Septic system UIC <br />ElServes z20 people/day <br />TITLE: ❑ Receives other than sanitary waste <br />Other disposal methods- <br />JT4 Os ❑ D wells/French Drains <br />REC <br />(-YD 23-02-002 REV 8108 <br />