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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMEN' <br /> 304 L,.st Weber Avenue, 3rd Floor, Stockton,CA 952L -2708 <br /> Telephone: (209)468-3420 Fax:(209)468-3433 Web: www.sjgov.orp,/ehd <br /> s <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> ��DQSb AUG l 4 PN 2� <br /> Facility address: US� 5 `k j p, ?� khT Y i f <br /> l�tidT" t <br /> Facility Contact: Title: Phone: <br /> Monitoring Panel: Piping system: Al,=y5 �'�'r Overfill prevention: <br /> �� CJ Pressurized D Suction ❑GravityT'H 2'Mechanical D Audible/visual <br /> Inspection type: — Violations: <br /> 9Routine LAlonitorin>Certification D Installation D Other: MI-RDetect D lV12-RPrev D M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=Califomia Code of Regulations V R V=Violation;RV=Re eat Violation V <br /> I 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 NSC 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 1 CCR 2712(i) Monitorin &res onse 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 M1 <br /> I 1 CCR 2630(d) UST system monitoring equipment is properllocated to detect a leak M1 <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 M1 <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 piping flow to a collection sum <br /> 17 HSC 25291 (f) Line leak detector(s)are installed M1 <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 (c) Water in 2'containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases M1 <br /> 23 1 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 M1 <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test M1 <br /> 28 CCR 2661 Repair for tank/piping has had tightness test M2 <br /> 29 1 CCR 2643(e) Biennial tightness test of gravity piping(pre-January 1, 1984 <br /> 30 CCR 2643(d) Triennial line test for conventional suction piping(pre-January1, 1984 M1 <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 HSC 25298(b) Permit to temporarily close UST system <br /> 35 1 HSC 25298(c) Permit to close UST system <br /> 36 HSC 25299(a)(9) Disabling leak detection devices <br /> 37 I ISC 25298(a) Illegal abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> ,. _.... ..,F 1•; ,:...r' -rr '11 X30 2;'I t Se tic system: <br /> ` Serves>_20 people/day <br /> RECEIVED BY: TITLE: C Receives other than sanitary waste <br /> Other disposal methods: <br /> Dry wells/French Drains <br /> 1'141)2i-02-002 <br />