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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3`d Floor,Stockton,CA 9520 2708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> �f+►� ��s cs.ri hrfastt— Rte) s.a�y�tE� <br /> 0�-1t—per <br /> Facility address: UST# <br /> i Z 3 <br /> Product 9 tr <br /> Facility Contact: Title: Phone: <br /> �j r=r=F c r►N Avc-w►�r� �-g-S S S �S <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> R-S- 3sr Pressurized ❑Suction ❑Gravity Mechanical ❑Audible/visual <br /> Inspection type: Violations: <br /> Routine /Monitoring Certification ❑Installation ❑Other: ❑Ml-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=California Code of Regulations V R 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 1 CCR 2712(i) Monitoring&response plan is onsite ✓ <br /> 7 CCR 2712(b) Maintenance&monitoring records (M1 <br /> 8 CCR 2643(d) Daily monitoringof 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 MI),, <br /> 11 CCR 2630 d UST system monitoring equipment is properly located to detect a leak MI <br /> 12 1 HSC 25291 UST system monitoring equipment is operational 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 piping flow to a collection sum <br /> 17 HSC 25291 ( 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 t/ <br /> 22 CCR 2650 Recordin eporting of unauthorized releases'` Mi <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-c)Monthly inspection; f)Employee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (Ml) <br /> 26 1 HSC 25284.2 Annual spill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test Ml <br /> 28 CCR 2661 (f) Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643 e) Biennial tightness test of gravity piping( re-Janus 1, 1984) <br /> 30 CCR 2643(d) Triennial line test for conventional suction piping(pre-January 1, 1984) (Mi) <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 1 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 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 INSPECTOR: PHONE: UIC <br /> Septic system: <br /> Serves>_20 people/day <br /> RECEIVED BY: TITLE: n Receives other than sanitary waste <br /> W Dry Other disposal methods: <br /> wells/French Drains <br /> F,HD 23-02-002 <br />