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1� SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, aid Floor, Stockton,CA 95202-2708 <br /> � • i <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> UNDERGROUNDO GET (UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> 06 AV <br /> Pin <br /> Facility address: <br /> 171 <br /> Product / 411 <br /> Facility Contact: Title: Phone: <br /> q #11f <br /> Al WN - I[ <br /> Mpni oring Panel: Piping syst m: Overfill prevention: <br /> . Pressurized El Suction ❑Gravit ❑Mechanical Audible/visual <br /> Inspection type: Violations: <br /> Routine Monitoring Certification ❑Installation ❑Other: ❑M1-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V <br /> # Code Section V=Violation;RV=Re eat Violation V <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 res2onsibility 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 (MI) <br /> 8 CCR 2643 d Daily monitoring of suction 2i2ing(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 l <br /> 11 CCR 2630(d) UST system monitoring equipment is properly located to detect a leak (MI) <br /> 12 HSC 25291 UST system monitorinE equipment iso erational M2 <br /> 13 CCR 2636(f)(1 Continuous monitoring system for under ound piping&UDC is present (Ml) <br /> 14 CCR 2631 a Primary containment is product ti ht <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in second2a 2ipingflow to a collection sum <br /> 17 HSC 25291 f) Line leak detector(s)are installed Ml <br /> 18 CCR 2635(b)(1) S ill container M2 <br /> 19 1 CCR 2635(b (2 Overfill prevention system (M2) <br /> 20 CCR 2636(a) Conventional suction i2ing shall have continuous monitoring&21 containment <br /> 21 HSC 25291 (e) Water in 21 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recordin /reporting of unauthorized releases —�( l <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly inspection; f)Employee vainin <br /> F <br /> 24 CCR 2638 a) Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test • (Ml) <br /> 26 HSC 25284.2 Annuals ill containment testing 27 CCR 2636 f)(4) Annual line tightness test (Ml) <br /> 28 CCR 2661 Repair for tank/pipinghas had ti htness test M2 <br /> 29 CCR 2643(e) Biennial tightness test of gravityi in ( re-Januar 1, 1984) ` <br /> 30 CCR 2643(d Triennial line test for conventional suction i in re-Januar 1, 1984 Ml <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 monitorinE system <br /> 34 HSC 25298(b) 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 1 Other: <br /> EHD INSP CTOR: PHONE: Septic <br /> tic system: <br /> (n ❑Serves>_20 people/day <br /> R CEIVE TITLE ❑Receives other than sanitary waste <br /> Other disposal methods: <br /> J ❑Dry wells/French Drains <br /> EHD 23-02 <br /> 1/3/07 <br />