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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.sjjzov.orgJehd <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility name: <br />(LUAq:-- <br />mei,A <br />Designated Operator: Inspection Date: <br />L/-y—aG <br />Facility addre : <br />UST # <br />Product <br />1 <br />a <br />, <br />Fa ility Contact: <br />Title: Phone: <br />onitoring Panel: V <br />L� <br />Piping system: <br />❑ Pressurized ❑ Suction ❑ Gravity <br />Overfill prevention: <br />Mechanical ❑ Audible/visual <br />Inection type: <br />routine Nf>zonitoring Certification ❑ Installation ❑ Other: <br />Violations: <br />❑ M1-RDetect ❑ M2-RPrev M-3 Both <br /># <br />Code Section`. <br />VIOLATIONS) HSC=California Health & Safety Code; CCR=California Code of Regulations V R <br />V=Violation; RV=Re eat Violation <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 />CCR 2632 c) 2 D <br />Monitoring & response plan is current and filed with the local agency <br />6 <br />CCR 2712 i <br />Monitoring & response plan is onsite <br />7 <br />CCR 2712 b <br />Maintenance & monitoring records <br />(Ml) <br />8 <br />CCR 2643 d <br />Daily monitoring of suction piping (pre -January, I, 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 <br />Ml <br />11 <br />CCR 2630 d <br />UST system monitoring equipment is properly located to detect a leak <br />M1 <br />12 <br />HSC 25291 <br />UST system monitoring equip ment isoperational <br />M2 <br />13 <br />CCR 2636 1 <br />Continuous monitoring system for underground piping & UDC is present <br />M1 <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)(1) <br />All releases in secondary pipingflow to a collection sum <br />17 <br />HSC 25291 <br />Line leak detectors are installed <br />Ml <br />18 <br />CCR 2635 1) <br />Spill container <br />(M2 <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system <br />(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 />CCR 2650 <br />Recording/reporting of unauthorized releases <br />M1 <br />23 <br />CCR 2715 <br />Designated Operator: (a) Statement from UST owner; (c -e) Monthly ins ection <br />m to ee training <br />24 <br />CCR 2638 a <br />Annual monitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test <br />(M1) <br />26 <br />HSC 25284.2 <br />Annuals ill containment testing <br />27 <br />CCR 2636 4) <br />Annual line tightness test <br />M1 <br />28 <br />1 CCR 2661 <br />Repair for tank/piping has had tightness test <br />M2 <br />29 <br />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 -January 1, 1984) <br />(MI) <br />31 <br />FISC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <br />32 <br />CCR 2661 <br />Permit to repair UST system <br />33 <br />HSC 25286 a <br />Permit to alter monitoring system <br />34 <br />1 HSC 25298 <br />Permit to temporarily close UST system <br />35 <br />HSC 25298 c <br />Permit to close UST system <br />-36 <br />HSC 25299 (a)(9) <br />Disabling leak detection devices <br />37 <br />HSC 25298 a <br />Illegal abandonment of UST system <br />38 <br />Other: <br />PRE <br />4N S1 O <br />PHONE: / <br />Septic system: <br />.. Serves >_20 p e/day <br />❑ Receives er than sanitary waste <br />Other di 1 methods: <br />Ci wells/French Drains <br />E 7B— <br />TITLE: <br />F.HD 23-02-002 <br />