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SAN JOAQUIN COUNTY t VIRONMENTAL HEALTH DEPARTMENT 304 East Weber Avenue, 3`d Floor Stockton CA 9520T-"708 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sj ov.or /g ehd UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT Facility name: K�&h(L sc--g-wc Designated Operator: Inspection Date: Facility address: UST # , Product 5 L— Facility Contact: Title: Phone: , Vf-$nitoring Panel: TS 3 S D Piping system: Pressurized ❑ Suction ❑ Gravity Overfill prevention: Mechanical ❑ Audible/visual Inspection type: ❑ Routine Monitoring Certification ❑ Installation ❑ Other: olations: MI-RDetect ❑ M2-RPrev ❑ M-3 Both # Code Section VIOLATION(S) HSC=California Health &Safety Code; CC =California Code of Regulations V R V=Violation; RV=Re eat Violation `, 1 HSC 25284 Permit tooperate 2 CCR 2637 Secondary containment test;performed> 3 CCR 2711 b & c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form 4 HSC 25292.2 Certification of financial responsibility and CFO letter 5 CCR 2632 c (2)(D) Monitoring & response plan is current and filed with the local agency 6 1 CCR 2712{i) Monitoring & response plan is onsite 7 CCR 2712 (b) Maintenance & monitoring records Ml 8 CCR 2643 (d) Daily monitoring of suction piping (pre -January, 1, 1984 9 HSC 25292.1 UST system isoperated to prevent unauthorized release 10 CCR 2632` (c)(2) UST monitoring system is present Ml 11 CCR 2630 (d) UST system monitoring equipment is properly erl located to detect a leak Ml 12 HSC 25291 b UST system monitoring equipment isoperational M2 13 CCR 2636 1 Continuous monitoring system for underground piping & UDC is present Ml 14 CCR 2631' a Primary containment is, roduct tight 15 HSC 25291 (a)(2) Secondary containment for UST is tight P6 CCR 2636 (c)(1) All releases in secondary pipingflow to a collection sump 17HSC 25291 Line leak detector(s) are installed Ml 18 CCR 2635 (b)(1) Spill container (M2 19 CCR 2635 (b)(2) Overfill prevention system (M2 20 CCR 2636 (a) Conventional suction piping shall have continuous monitoring & 2° containment 21 HSC 25291 (e) Water in 2° containment analyzed & properly disposed of 22 CCR 2650 Recording/reporting of unauthorized releases Mi 23 CCR 2715 Desiggated O erator: (a) Statement from UST owner; (c -e) Monthly inspection; (f) Em loyee training CCR 2638 a Annual monitoring certification 25 CCR 2638 (a) Annual line leak detector test (Ml) 26 HSC 25284.2 Annual spill containment testing 27 CCR 2636 4 Annual line ti hmess test (MI) 28 CCR 2661,(f) Repair for tank/piping has had tightness test (M2) 29 CCR 2643 e Biennial tightness test of gravity pipingre-Janus 1, 1984 30 CCR 2643- d Triennial line test for conventional suction piping (pre -January 1, 1984 (Mi) " .31 HSC 25292.5 Double walls stem located within 1000' of public well-ELD 32 CCR 2661 Permit to repair UST system 33 HSC 25286 a Permit to alter monitoring system 34 HSC 25298 (b) Permit to temporarily close UST system 35 HSC 25298 c Permit to close UST system 36 HSC 25299 (a)(9) Disabling leak detection devices 37 HSC 25298 a Illegal abandonment of UST system 38 Other: EHD INSPECTOR: V v tUU4 N („ V� PHONE: / b� —3 l O l UIC Septic system: El Serves >_20 people/day ❑ Receives other than sanitary waste Other disposal methods: .i Dry wells/French Drains RECEIVED TITLE: EHD 23-02-002