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DATE ®C( <br /> SAN JOAQUIN COUNTY PR# <br /> ENVIRONMENTAL HEALTH DEPARTMENT PAGE Z <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_ Q-�,'t td4m �vc t Facility Address (s)e54, <br /> Facilty Contact `�c_�- __Title Cgr_ Phone <br /> UST#--, Product UST# ?—Product l UST# Product UST/# Product <br /> Overfill Prevention: ❑AudibleNisual Mechanical Monitoring Panel: <br /> Piping System: ❑Gravity gPressure ❑Suction Violations: ❑ M1-RDet ❑M2-Rprev ❑ M3-Both <br /> Automatic Purne Shut Down Satisfies CCR 2636 5 ❑Yes Flo Desi nated Q erator: <br /> INSPECTION TYPE: outine onitoring Certification ❑Complaint ❑Install ❑Removal ❑Repair/Upgrade <br /> COMPANY NAME: a�­ TECHNICIAN NAME: 1lS 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 23 CCR 2643 (d) Daily monitoring of suction <br /> 2 CCR 2637 Secondary cont. testing piping (pre-1/1/84) <br /> 3 CCR 2711(b)&;(c) Current State Forms A& B 24 CCR 2636 (a) Conventional suction piping <br /> 4— HSC 25292.2 Certification of financial shall have continuous <br /> responsibility& CFO letter monitoring &20 containment <br /> 5- CCR 2632 (c)(2) UST monitoring is present(M1) 25 CCR 2643 (e) Biennial tightness test of gravit, <br /> 6 CCR 2630 (d) UST system monitoring piping (pre-1/1/84) <br /> equipment is properly located to 26 CCR 2643 (d) Triennial line test for <br /> detect a leak(M1) conventional suction (pre- <br /> 7 HSC 25291 (b) UST system monitoring 1/1/84)(M1) <br /> equipment is operational (M1) 27 CCR 2661 Permit to repair UST system <br /> 8 CCR 2636 (f)(1) Continuous monitoring system 28 HSC 25286 (a) Permit to alter monitoring <br /> for underground piping & UDC system <br /> is present(M1) 29 HSC 25298 (a) Illegal abandonment of UST <br /> 9 CCR 2636 (c)(1) All releases in secondary piping system <br /> flow to a collection sump 30 HSC 25298,(b) Permit to temporarily close US- <br /> 10 HSC 25291 (f) Line leak detector(s)(M1) system <br /> 11 HSC 25291(a)(2) Secondary containment for 31 HSC 25298 (c) Permit to close UST system <br /> UST is tight 32 HSC 25292.1 UST system is operated to <br /> 12 CCR 2635(b)(1) Spill container(M2) prevent unauthorized release <br /> 13 NSC 25284.2 Annual spill container testing 33 CCR 2650 Recording/reporting <br /> 14 CCR 2635(b)(2) Overfill prevention system (M2) unauthorized release (M1) <br /> 15 CCR 2631 (a) Primary containment is product- 34 HSC 25291 (e) Water in 20 cont analyzed and <br /> tight properly disposed of <br /> 16 CCR 2632 (c)(2)(D)Monitoring& response plan 35 CCR 2640 (e) Single wall component within , <br /> 17 CCR 2712 (i) Monitoring & response plan is 1 000'of Public Well, no ELD <br /> on site 36 CCR 2635(a)(2)(A)Cathodic protection testing & <br /> 18 CCR 2712 (b) Maintenance & monitoring 60 day inspection log (M2) <br /> records(M1) 37 HSC 25299(a)(9) Disabling leak detect. Devices <br /> 19 %/CCR 2636 (f)(4) Annual line tightness test 38 CCR 2715(a) Statement from UST owner <br /> 20_ve CCR 2638 (a) Annual line leak detector test 39 CCR 2715(c) Monthly inspection by D.O, <br /> (M1) 40 CCR 2715 (f) D.O.trained employees <br /> 21 CCR 2638(a) Annual monitoring certification 41 Violation(s) not listed above <br /> 22 CCR 2661 (f) Repair for tank/piping has had <br /> ti htn4test, M2 <br /> EHD INSPECTOR: PHONE: GI 1S <br /> RECEIVED BY TITLE: <br /> Septic S$stem: ❑Serves Z 20 rsons/day ❑Receives other than sanitary waste <br /> Other Disposal Units Identified: ❑Dry wells/French Drains <br /> l U'\Unit-II1XUS nUST inspection915 04.DOC <br />