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SAN JOAQUIN COUNTY <br /> ,NVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3'd Floor,Stockton,CA 95202-,708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sj og v.or ehd <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: in ection ate: <br /> J SerU r�XA- <br /> Facility addreCss: /_ <br /> Product LM <br /> CJ <br /> Facility Contact: Title: Phone: <br /> nitoring anel: Piping system: Overfill prevention: <br /> ❑Pressurized ❑Suction ) Gravity 1 Mechanical udible/visual <br /> Lns ection type: Violations: <br /> outine ❑Monitoring Certification ❑Installation ❑Other: Ml-RDetect M2-RPrev ❑M-3 Both <br /> VIOLATIONS) HSC=California Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section <br /> V=Violation;RV=Re eat Violation � <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 b & c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 c 2 D Monitoring&response plan is current and filed with the local agency <br /> 6 CCR 2712 i Monitoring&response plan is onsite <br /> 7 CCR 2712 b Maintenance&monitoring records M1 <br /> 8 CCR 2643(d) Daily monitoring of suction piping(pre-January, 1, 1984 <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632 c)(2) UST monitoring system is present Ml <br /> 11 CCR 2630(d) UST system monitoring equipment is properly located to detect a leak Ml <br /> 12 HSC 25291 (b) UST system monitoring equipment isoperational M2 <br /> 13 CCR 2636(f)(1) Continuous monitoring system for underground piping&UDC is present Ml <br /> 14 CCR 2631 a Primary containment is product tight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in secondary pipingflow to a collection sum <br /> 17 HSC 25291 (f) Line leak detectors are installed Ml <br /> 18 CCR 2635(b)(1) Spill container (M2 <br /> 19 CCR 2635(b)(2) Overfill prevention system M2 <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases Ml <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly inspection;(f)Employee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test MI <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test MI <br /> 28 1 CCR 2661 Repair for tank/piping has had tightness test (M2 <br /> 29 CCR 2643 a Biennial tightness test of gravity piping( re-Janus 1, 1984) <br /> 30 CCR 2643 d Triennial line test for conventional suction piping(pre-January1, 1984 (Mi) <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 34 1 HSC 25298 Permit to temporarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> -36 HSC 25299(a)(9) Disabling leak detection devices <br /> 37 HSC 25298(a) Illegal abandonment of UST system <br /> 38 Other: <br /> EHD IN ECTOR: PHON UIC <br /> L ► �'�/�/'�� �j ell 1 S tics st <br /> 7 Serves_ 0 pe pie/day <br /> RECEIVED B .7 TIT E: --Receives o r than sanitary waste <br /> /�'^��, ���� Q Other <br /> lis <br /> sal h <br /> '�/'�- /�� wells/ rench ins <br /> EHD 23-02-002 <br />