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DATE <br /> SAN JOAQUIN COUNTY PR# <br /> ENVIRONMENTAL HEALTH DEPARTMENT 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 FreGi55r F1,J � Facility Address t42t I"-'I <br /> Facilty Contact D6n 1PN41%t Title 6LJ-k1f& Phone <br /> UST# Product UST#Product UST#Product UST# Product-,- <br /> Overfill Prevention: ❑AudibleNisual ❑Mechanical Monitoring Panel <br /> Piping System: ❑Gravity ❑ Pressure ❑Suction Violations: ❑ Minor ❑ Major <br /> Automatic Pum Shut Down Satisfies CCR 2636 ❑Yes❑ No Dispenser Pan: ❑Yes. D No <br /> INSPECTION TYPE: ?'1Routine ❑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 (6records <br /> month/36 month) 21 V CCR 2636 (f)(4) Annual line tightness test <br /> 3 CCR 2711(b)& (c) Current State Forms A&B 22 V CCR 2630 (d) Annual line'leak detector L,. . <br /> 4 HSC 25292.2 Certification of financial 23V-CCR 2630 (d) Annual monitoring certificai. <br /> responsibility and letter from 24 CCR 2643 (d) Daily monitoring of suction <br /> chief financial officer piping that is not continuoL:., <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 /> flow to a collection sump continuously monitored <br /> 7 HSC 25291 (e) Water in secondary(20)cont 26 CCR 2643 (e) Biennial tightness test of <br /> 8 HSC 25291 (f) Automatic line leak detector(s) piping that is not co tinuou <br /> 9 CCR 2636(f)(1) Continuous monitoring system monitored <br /> for underground piping 27 CCR 2662 Upgrade requirements for t <br /> 10 CCR 2632 (c)(2) Continuous monitoring system system <br /> for UST 28 CCR 2661 Permit to repair UST sysL-, <br /> 11 HSC 25291(a)(2) Secondary containment for 29 HSC 25286 (a) Permit to altar monitoring <br /> UST is tight system <br /> 12 CCR 2636 (f)(1) Continuous monitoring system 30 HSC 25298 (a) Illegal abandonment of US <br /> for dispenser system system <br /> 13 CCR 2635 (b)(1) Spill container 31 HSC 25298 (b) Permit to temporarily close <br /> 14 CCR 2635(b)(2) Overfill prevention system system <br /> 15 CCR 2631 (a) Primary containment is product- 32 HSC 25298 (c) Permit to close UST syst& <br /> tight 33 HSC 25291 (e) Water in 20 t analyzed <br /> 16 HSC 25292.1 UST system is operated to properly dtsppsed of <br /> prevent unauthorized release 34 CCR 2640 (e) Single;wall `„tampon nt unitlr- <br /> 17 CCR 2650 Recording/reporting 1000"of Pubic Well, no EL <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 leak detect, deviC <br /> 19 CCR 2712 (i) Monitoring &response plan is 37 violation(s)nsat li sted abo <br /> on site <br /> EHD INSPECTOR: �'�t-"�-' PHONE: <br /> RECEIVED BY: TITLE: PHONE: _ <br /> UNITOUSUINSP(rev 3/5/02) <br />