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SAN JOAQUIN COUNTY DATE o <br />P R# <br />ENVIRONMENTAL HEALTH DEPARTMENT PAGE Q <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 AFacility Address Uq I "AeA, 2 <br />Facilty Contact c f- Title Kt,JI�en— ( tt_'4/t- Phone # (-Zng S <br />UST# Productq UST#-LProduct_UST#_Product UST# Product <br />Overfill Prevention: ❑ AudibleNisual Vmechanical Monitoring Panel: <br />Piping System: ❑ Gravity `(.Pressure ❑ Suction Violations: ❑ Minor XMajor <br />Automatic Pump Shut Down Satisfies CCR 2636 (q): ❑ Yes*No Dispenser Pan: Yes ❑ No <br />INSPECTION TYPE: *outine Monitoring Certification []Complaint ❑Install ❑Removal ❑Repair/Upgrade <br />COMPANY NAME: <br />TECHNICIAN NAME: <br />VIOLATION(S) <br />PHONE: <br />The above facility is not in compliance with the following section(s) of Health & Safety Code (HSC) and/or <br />California Code of Regulations (CCR): <br />1 ' HSC 25284 <br />Permit to operate <br />2�CR 2637 <br />Secondary cont testing (6 <br />records <br />Annual line tightness test <br />month/36 month) <br />3 7 11(b) & (c) Current State Forms A & B <br />4_H 2.2 <br />4 5111* <br />Certification of financial <br />CCR 2630 (d) <br />responsibility and -letter from <br />24 <br />chief financial officer <br />5 CCR 2630 (d) <br />Continuous monitoring system <br />6 CCR 2636 (c)(1) <br />for UST system <br />All releases in secondary piping <br />flow to a collection sump <br />7HSC 25291 (e) <br />Water in secondary (20) cont <br />8 HSC 25291 (f) <br />Automatic line leak detector(s) <br />9;CCR 2636 (f)(1) <br />Continuous monitoring system <br />shall have continuous <br />for underground piping <br />10 ✓CCR 2632 (c)(2) <br />Continuous monitoring system <br />26 <br />for UST <br />11 ✓ HSC 25291(a)(2) <br />Secondary containment for <br />UST is tight <br />12 CCR 2636 (f)(1) <br />Continuous monitoring system <br />monitored <br />for dispenser system <br />13_CCR 2635 (b)(1) <br />Spill container <br />14 CCR 2635 (b)(2) <br />Overfill prevention system <br />15 CCR 2631 (a) <br />Primary containment is product - <br />Permit to repair UST system <br />tight <br />16 HSC 25292.1 <br />UST system is operated to <br />prevent unauthorized release <br />17 CCR 2650 <br />Recording/reporting <br />Illegal abandonment of UST <br />unauthorized release <br />18 CCR 2632 (d) <br />Monitoring & response plan <br />19 CCR 2712 (i) <br />Monitoring & response plan is <br />Permit to temporarily close US <br />on site <br />EHD INSPECTOR: <br />RECEIVED BY: <br />, y,m,,p, ietn.,gR+ b �. vp •,nog <br />20 <br />CCR 2712 (b) <br />Maintenance & monitoring <br />21�CCR 2636 (f)(4) <br />records <br />Annual line tightness test <br />22 <br />CCR 2630 (d) <br />Annual line leak detector test <br />23 <br />CCR 2630 (d) <br />Annual monitoring certification <br />24 <br />CCR 2643 (d) <br />Daily monitoring. of suction <br />piping that is not continuously <br />monitored <br />25 <br />CCR 2636 (a) <br />Conventional suction piping <br />shall have continuous <br />monitoring & 20 containment <br />26 <br />CCR 2643 (e) <br />Biennial tightness test of gravit <br />piping that is not continuously <br />monitored <br />27 <br />CCR 2662 <br />Upgrade requirements for UST <br />system <br />28 \/ 2661 <br />Permit to repair UST system <br />29_�_ZHSC 25286 (a) <br />Permit to alter monitoring <br />system <br />30 <br />HSC 25298 (a) <br />Illegal abandonment of UST <br />system <br />31 <br />HSC 25298 (b) <br />Permit to temporarily close US <br />--- <br />— — -- <br />-system --- <br />32 <br />HSC 25298 (c) <br />Permit to close UST system <br />33 HSC 25291 (e) Water in 20 cont analyzed and <br />properly disposed of <br />34 CCR 2640 (e) Single wall component within <br />1000' of Public Well, no ELD <br />35 CCR 2635(a)(2)(A) Cathodic protection testing <br />36 H&SC 25299(a)(9) Disabling leak detect. devices <br />37_I Violation(s) not listed above <br />H0,c. Zfzci <br />#.4s C ZS ?- <br />PHON <br />TITLE <br />