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SAN JOAQUIN COUNTY IR <br />ONVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjjzov.or <br />iTNnlFRf_RnilND RTnRAGR TANK (UST) PROGRAM INSPECTION REPORT <br />Facility na e•, <br />' " � � `' f' ' " " <br />Designated Operator: <br />�vy' � 1 W� A <br />Inspection Date: <br />� O' <br />Facility address- <br />UST # <br />Product <br />Facility Contac fj� A � � I Title: Phone: <br />mtoring Pan I. <br />I Piping system: <br />ressurized ❑ Suction ❑ GravityMechanical <br />Overfill prevention: <br />ElAudible/visual <br />Inspection type: <br />❑ Routine )6onitoring <br />Certification ❑ Installation ❑ Other: <br />Violations: <br />❑ MI-RDetect 2-RPrev ❑ M-3 Both <br /># Code Section <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=California Code of Regulations V R <br />V <br />V=Violation; RV=Re eat Violation <br />1 <br />HSC 25284 <br />Permit tooperate <br />2 <br />CCR 2637 <br />Secondary containment test performed <br />3 <br />CCR 2711 b) & c) <br />Current Unified Pro am Consolidated Forms on file with EHD(Facility and tank form) <br />4 <br />HSC 25292.2 <br />Certification of financial responsibility and CFO letter <br />5 <br />CCR 2632 b <br />Monitoring Program(Monitoring & Response Plan) is current and approved by the local agency. <br />6 <br />CCR 2712 (i) <br />Monitoring plan is onsite. <br />7 <br />CCR 2712 b <br />Maintenance & monitoring records (Mi) <br />8 <br />CCR 2643 d) <br />Daily monitoring of suction piping (pre -January, 1, 1984) <br />9 <br />HSC 25292.1 <br />UST system isoperated to prevent unauthorized release <br />10 CCR 2632 c)(2) <br />UST monitoring system is present (MI) <br />11 CCR 2630 d) <br />UST system monitoring equipment is properly located to detect a leak (Mi) <br />12 HSC 25291 b) <br />UST system monitoring equipment isoperational (M2) <br />13 CCR 2636 (f)(1) <br />Continuoussystem for underground piping & UDC is present (MI) <br />14 CCR 2631 a) <br />.monitoring <br />Primary containment is product tight <br />15 HSC 25291 (a)(2) <br />Secondary containment for UST is tight <br />16 CCR 2636 c)(1) <br />All releases in secondary pipingflow to a collection sum <br />17 HSC 25291 (f) <br />Line leak detector(s) are installed (Mi) <br />18 CCR 2635 b)(1) <br />Spill container (M2) <br />19 CCR 2635 (b)(2) <br />Overfill prevention system M2) <br />20 CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 2° containment <br />21 HSC 25291 (e) <br />Water in 2° containment analyzed & properly disposed of <br />22 CCR 2650 <br />Recording/reporting of unauthorized releases Ml <br />23 CCR 2715 <br />DesignatedOperator: (a) Statement from UST owner; (c -e) Monthly inspection; f) Employee training <br />24 CCR 2638 a <br />Annual monitoring certification <br />25 CCR 2638 (a) <br />Annual line leak detector test (M1) <br />26 HSC 25284.2 <br />Annuals ill containment testing <br />27 CCR 2636 (f)(4) <br />Annual line tightness test Ml <br />28 CCR 2661 (f) <br />Repair for tank/piping has had tightness test (M2) <br />29 CCR 2643 e) <br />Biennial tightness test of gravity pipingre-Janus 1, 1984) <br />30 CCR 2643 d) <br />Triennial line test for conventional suction piping (pre -January 1, 1984) (Ml) <br />31 HSC 25292.5 C <br />Double walls stem located within 1000' of public well-ELD <br />32 CCR 2661 <br />Permit to repair UST system <br />33 HSC 25286 a) <br />Permit to alter monitoring system <br />34 HSC 25298 (b) <br />Permit to temporarily close UST system <br />35 1 HSC 25298 c) <br />Permit to close UST system <br />36 HSC 25299 a)(9) <br />Disabling leak detection devices <br />37 HSC 25298 a) <br />Illegal abandonment of UST system <br />38 Other: <br />F. DIN E OR: <br />PHO E: <br />I^ <br />1(J <br />UIC <br />Septic system: <br />-Serves >_20 people/day <br />^ Receives other than sanitary waste <br />Other disposal methods: <br />1j Dry wells/French Drains <br />RECEIVE BY: <br />TIT E: <br />EHD 23-02-002 REV 05/07 <br />