Laserfiche WebLink
SAN JOAQUIN COUNTY <br />*NVIRONMENTAL HEALTH DEPARTMEN <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.segov.org/ehd <br />UNDERGROUND STORAGE TANK (USTI PROGRAM INSPECTION REPORT <br />Facility name: Designated Operator: Inspection <br />'11 CIr Y P M Date: —/' <br />Facility address: \ UST # " <br />-CAt 'Product <br />Code Section <br />/ " <br />-y <br />Facility Contact: Title: Phone: <br />P,RA--.*&- <br />CCR 2637 <br />3 <br />CCR 2711 b & 1 <br />D - - - A &: <br />HSC 25292.2 <br />5 <br />CCR 2632 (b) <br />MM <br /># <br />Code Section <br />1 <br />HSC 25284 <br />2 <br />CCR 2637 <br />3 <br />CCR 2711 b & 1 <br />4 ® <br />HSC 25292.2 <br />5 <br />CCR 2632 (b) <br />6 <br />CCR 2712 i <br />7 <br />CCR 2712 b <br />8 <br />CCR 2643 d <br />9 <br />HSC 25292.1 <br />10 <br />CCR 2632 (c)(2) <br />11 <br />CCR 2630 d <br />12 <br />HSC 25291 b <br />13 <br />CCR 2636f�1 <br />14 <br />CCR 2631 (a) <br />15 <br />HSC 25291 (a)(2 <br />16 <br />CCR 2636 (c)(1) <br />17 <br />HSC 25291 (f) <br />18 <br />CCR 2635 (b)(1) <br />19 <br />CCR 2635 (b)(2) <br />20 <br />CCR 2636 (a) <br />21 <br />HSC 25291 (e) <br />22 <br />CCR 2650 <br />23 <br />CCR 2715 <br />24 • <br />CCR 2638 a <br />25 ® <br />CCR 2638 a <br />26 <br />HSC 25284.2 <br />27 <br />CCR 2636 (f)(4) <br />28 <br />CCR 2661 (>) <br />29 <br />CCR 2643 (e) <br />30 <br />CCR 2643 d <br />31 <br />HSG 25292.5 <br />32 <br />CCR 2661 <br />33 <br />HSC 25286 (a) <br />34 <br />HSC 25298 b <br />35 <br />HSC 25298 (c) <br />36 <br />HSC 25299 <br />a 9 2 <br />37 <br />38 <br />HSC 25298 a <br />Other: <br />• - - - vverrm prevention: <br />Pressurized ❑ Suction ❑ Gravi ❑ Mechanical Audible/visual <br />Violations: <br />Certification ❑ Installation ❑ Other: ❑ M1-RDetect > 2-RPrev ❑ M-3 Both <br />VIOLATION(S) HSC=Califomia Health & Safety Code; CCR=California Code of Regulations V R <br />V=Violation; RV=Re eat Violation V <br />Permit to operate,& - <br />Secondary containment test performed [*&+w 7,012 <br />Current Unified Program Consolidated Forms on file with EHD Facili and nk form <br />Certification of financial responsibility and CFO letter <br />Monitoring Program(Monitoring & Response Plan is current and approved by the local a enc .43 <br />Monitorin Ian is onsite.dV— <br />Maintenance & monitoring records M1 <br />Daily monitoring of suction piping (pre -January, 1, 1984 <br />UST system isoperated to prevent unauthorized release <br />UST monitoring system is present (M1) <br />UST system monitoring a ui ment is properly located to detect a leak Will <br />erational (M1) <br />ground pipinq & UDC is present IM91 <br />All relea <br />Line leak detectors are <br />Spill container k g <br />Overfill prevention syste <br />Conventional suction pir <br />Water in 2 containment <br />tem monitoring equipment is o <br />)us monitoring system for under <br />containment is product tight <br />In containment for UST is tight <br />ses in secondary piping flow to a <br />shall have continuous monitor <br />4ged &properly disposed of <br />thorized releases <br />atement from UST owner; (c-( <br />Annual line leak detector test <br />Annuals ill containment testin <br />Annual line tightness test <br />Repair for tank/piping has had tightness test <br />Biennial tightness test of gravity piping (pre-, <br />Triennial line test for conventional suction pil <br />Double wall system located within 1000' of a <br />Permit to temporarily close UST <br />Permit to close UST system <br />Disabling leak detection devices <br />Illegal abandonment of UST sys <br />1. 1 <br />g & 20 containment <br />Monthly inspection; <br />•7._ O, <br />-03 _ <br />ry 1. 19841 <br />901 Septic system: <br />RECEIVE ❑ Serves ?20 people/day <br />TITLE: ❑ Receives other than sanitary waste <br />Other disposal methods: <br />❑ Dry wells/French Drains <br />EHD 23-02-002 REV 8/08 <br />