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I <br /> DATES- O <br /> SAN JOAQUIN COUNTY PR# <br /> ENVIRONMENTAL HEALTH DEPARTMENT PAGE 1 �-- <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 �� I �[o .�S Facility Address —� +e <br /> Facilty Contact Title Phone# � q'�— 5662 <br /> UST# Produc 6a�.UST# roduct UST# Product UST# Product <br /> Overfill Prevention: 'V AudibleNisual ❑ Mechanical Monitoring Panel: <br /> 01h 6,- <br /> Piping System: KGravity ❑Pressure ❑ Suction Violations: inor ❑ Major <br /> 0 IN- <br /> Automatic Pum Shut Down Satisfies CCR 2636 : ❑Yes o Dispenser Pan: ❑Yes ❑ No <br /> INSPECTION TYPE: poutine ❑Monitoring Certification ❑Complaint ❑Install ❑Removal ❑Repair/Upgrade <br /> COMPANY NAME: TECHNICIAN NAME: PHONE: <br /> VIOLATION(S) <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 Permit to operate 20 CCR 2712 (b) Maintenance& monitoring <br /> 2 CCR 2637 Secondary cont testing (6 records <br /> month/36 month) 21 CCR 2636 (0(4) Annual line tightness test <br /> 22 CCR 2630 d Annual line leak detector test <br /> 3 CCR 2711(b) & (c) Current State Forms A& B <br /> 4_�Z HSC 25292.2 Certification of financial 23 ✓` CCR 2630 (d) Annual monitoring certification <br /> responsibility and letter from 24 CCR 2643 (d) Daily monitoring of suction <br /> chief financial officer piping that is not continuously <br /> 5 CCR 2630 (d) Continuous monitoring system monitored <br /> for UST system 25 CCR 2643 (d) Triennial tightness test of <br /> 6 CCR 2636 (c)(1) All releases in secondary piping suction piping that is not <br /> continuously monitored <br /> flow to a collection sump <br /> 7 HSC 25291 (e) Water in secondary(20) cont 26 CCR 2643 (e) Biennial tightness test of gravi <br /> piping that is not continuously <br /> 8 HSC 25291 (f) Automatic line leak detector(s) monitored <br /> 9 CCR 2636 (f)(1) Continuous monitoring system 27 CCR 2662 Upgrade requirements for US' <br /> for underground piping system <br /> 10 CCR 2632 (c)(2) Continuous monitoring system 28 CCR 2661 Permit to repair UST system <br /> for UST <br /> 29 HSC 25286 (a) Permit to alter monitoring <br /> 11 HSC 25291(a)(2) Secondary containment for system <br /> UST is tight <br /> 30 HSC 25298(a) Illegal abandonment of UST <br /> 12 CCR 2636 (f)(1) Continuous monitoring system system <br /> for dispenser system <br /> 31 HSC 25298 (b) Permit to temporarily close U� <br /> 13 CCR 2635(b)(1) Spill container <br /> system <br /> 14 CCR 2635(b)(2) Overfill prevention system <br /> 15 CCR 2631 (a) Primary containment is product- 32 HSC 25298 (c) Permit to close UST system <br /> tight 33 HSC 25291 (e) Water in 20 cont analyzed an <br /> 16 HSC 25292.1 UST system is operated to <br /> properly disposed of nt within <br /> prevent unauthorized release 34 CCR 2640 (e) 5000 of Public Wellingle wall , no ELD <br /> 17 CCR 2650 Recording/reporting <br /> unauthorized release 35 CCR 2635(a)(2)(A)Cathodic protection testing <br /> 18 ✓ CCR 2632 (d) Monitoring & response plan 36 H&SC 25299(a)(9)Disabling <br /> s li le k dot etect.t above <br /> device <br /> 19�CCR 2712 (i) Monitoring & response plan is 37Violation(s) <br /> on site <br /> EHD INSPECTOR: <br /> PHONE: <br /> RECEIVED BY: ITLE: PHONE: <br /> UNITIIUUST/INSP(rev 315/02) <br />