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SAN JOAQUIN COUNTY DATE /IIS ZAO <br />PR# <br />LoWIRONMENTAL HEALTH DEPARTNit-NT PAGE / <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 -( l / Facility Address4�9 A/, AX,Al JE ZAKZ T <br />Facilty Contact, <br />Title <br />Phone # <br />UST# I Product Q ( UST# ZProduct8�t UST#_Product, <br />Overfill Prevention: ❑ Audible/Visual &1 lechanical <br />Piping System: ❑ Gravity Vpressure ❑ Suction <br />Automatic Pump Shut Down Satisfies CCR 2636 (g): Yes E No <br />INSPECTION TYPE: ❑Routine ❑Monitoring Certification ❑Complaint <br />COMPANY NAME: <br />TECHNICIAN NAME: <br />VIOLATION(S) <br />UST# Product <br />Monitoring Panel: I '�—& <br />Violations: ❑ inor ❑ Major <br />Dispenser Pan: P'Yes ❑ No <br />❑Removal ❑Repair/Upgrade <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 <br />HSC 25284 <br />Permit to operate <br />2 <br />CCR 2637 <br />Secondary cont testing (6 <br />21 <br />CCR 2636 (f)(4) <br />month/36 month) <br />3 <br />CCR 2711(b) & (c) Current State Forms A & B <br />4 <br />HSC 25292.2 <br />Certification of financial <br />Annual monitoring certification <br />24 <br />responsibility and letter from <br />Daily monitoring of suction <br />chief financial officer <br />5 <br />CCR 2630 (d) <br />Continuous monitoring system <br />monitored <br />25 <br />for UST system <br />6 <br />CCR 2636 (c)(1) <br />All releases in secondary piping <br />shall have continuous <br />flow to a collection sump <br />7 <br />HSC 25291 (e) <br />Water in secondary (20) cont <br />8 <br />HSC 25291 (f) <br />Automatic line leak detectors) <br />9 <br />CCR 2636 (f)(1) <br />Continuous monitoring system <br />monitored <br />27 <br />for underground piping <br />10 <br />CCR 2632 (c)(2) <br />Continuous monitoring system <br />system <br />28 <br />for UST <br />11 <br />HSC 25291(a)(2) <br />Secondary containment for <br />Permit to alter monitoring <br />UST is tight <br />12 <br />CCR 2636 (f)(1) <br />Continuous monitoring system <br />Illegal abandonment of UST <br />for dispenser system <br />13 <br />CCR 2635 (b)(1) <br />Spill container <br />14 <br />CCR 2635 (b)(2) <br />Overfill prevention system <br />15 <br />CCR 2631 (a) <br />Primary containment is product - <br />Permit to close UST system <br />tight <br />16 <br />HSC 25292.1 <br />UST system is operated to <br />prevent unauthorized release <br />17 <br />CCR 2650 <br />Recording/reporting <br />unauthorized release <br />18 <br />CCR 2632 (d) <br />Monitoring & response plan <br />19 <br />CCR 2712 (i) <br />Monitoring & response plan is <br />on site <br />EHD INSPECTOR: <br />RECEIVED BY: <br />UNITIII/UST/INSP (rev 7/24/02) <br />20 <br />CCR 2712 (b) <br />Maintenance & monitoring <br />records <br />21 <br />CCR 2636 (f)(4) <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 gravity <br />piping that is not continuously <br />monitored <br />27 <br />CCR 2662 <br />Upgrade requirements for UST <br />system <br />28 <br />CCR 2661 <br />Permit to repair UST system <br />29 <br />HSC 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 UST <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 />1 000'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 Violation(s) not listed above <br />TITLE: <br />