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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />TTNDRRGROITND gTORAGF, TANK (UST) PROGRAM INSPECTION REPORT <br />Facility name: <br />Designated Operator: <br />Inspection Date: <br />IAN 6100 fff)Ov <br />f12A /0 7 <br />Facility address: <br />UST# <br />131 Ol .N i� I N r � <br />Product <br />g% <br />Facility Contact: <br />Title: Phone: <br />Sarn1pft;13 `b H S pA ctox VC*0 2--3' 32-5 2 - <br />Monitoring Panel: <br />Monitoring <br />Piping system: <br />Overfill prevention: <br />TLS - /� , V <br />I pressurized ❑ Suction ❑ Gravity <br />Ok(4echanical ❑ Audible/visual <br />Inspection type: <br />Violations: <br />C>l�outine <br />N4onitoring <br />Certification ❑ Installation ❑ Other: <br />❑ M I-RDetect ❑ M2-RPrev <br />❑ M-3 Both <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=Califomia Code of Regulations <br />V R <br /># <br />Code Section <br />V=Violation; RV=Re eat Violation <br />V <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 />5 <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 & monitoringrecords <br />(Mi) <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 />CCR 2632 (c)(2) <br />UST monitoringsystem is resent <br />M1 <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 equipment isoperational <br />(M2 <br />13 <br />CCR 2636 1 <br />Continuous monitoring system for underground piping &UDC is present <br />(Ml) <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 piping flow to a collection sum <br />17 <br />HSC 25291 <br />Line leak detector(s) are installed <br />(M1 <br />18 <br />CCR 2635 (b)(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 & 20 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 inspection; (f) Employee training <br />24 <br />CCR 2638 a <br />Annual monitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test <br />(MI) <br />26 <br />HSC 25284.2 <br />Annuals ill containment testing <br />VIM <br />27 <br />CCR 2636 (f)(4) <br />Annual line tightness test <br />MI) <br />28 <br />CCR 2661 <br />Repair for tank/piping has had tightness test <br />M2 <br />29 <br />CCR 2643 e) <br />Biennial tightness test of gravity pipingre-Januar 1, 1984) <br />30 <br />CCR 2643 d <br />Triennial line test for conventional suction piping (pre-January1, 1984) <br />Ml <br />31 <br />HSC 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 />HSC 25298 b <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 />EHD INSPECTOR: <br />�M ��l <br />PHONE: <br />�!'' /1.� � , � � <br />UIC <br />Septic system: <br />M - F'I � <br />❑Serves Z20 people/day <br />11 Receives other than sanitary waste <br />RECEIVY:�_ <br />TITLE: <br />- -- <br />Other disposal methods: <br />Drains <br />❑ Dry wells/French <br />EHD 23-02 <br />1/3/07 <br />