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— SAN JOAQUIN COUNTY Amok <br />~ NVIRONMENTAL HEALTH DEPARTMEN <br />304 East Weber Avenue, 3`d Floor, Stockton, CA 9520 -- 08 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.si og v.or <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility name: <br />Code Section <br />Designated Operator: <br />V R <br />V <br />Inspection Date: <br />• Ul P <br />Permit tooperate <br />ON4W 6fJq1AJ6C-91AJ& <br />2. <br />CCR 2637 <br />Facility address: <br />UST #i <br />CCR 2711 & c <br />Current Unified Pro am Consolidated Forms on file with EHD(Facility and tank form <br />4' <br />HSC 25292.2 <br />Product <br />5 <br />CCR 2632 c 2 D <br />Facility Contact: Title: <br />Phone: <br />6' <br />CCR 2712 .1) <br />Monitvrin ',& res onse Rlan is onsite <br /><S IN 6 (WN <br />'23-- 76 <br />Maintenance & monitoring records <br />l <br />8' <br />CCR 2643 d <br />Monitoring Panel: <br />Piping system: <br />9 <br />prevention: <br />UST system isoperated to grevent unauthorized release <br />rAILM60 We- <br />C�ressurized ❑ Suction <br />11Gravit <br />,O,_,,vve/erfill <br />LKMechanicai ❑ Audible/visual <br />Inspection type: <br />I I <br />Violations: <br />Routine N4onitoring Certification ❑ Installation <br />❑ Other: <br />❑ M1-RDetect ❑ M2-RPrev <br />❑ M-3 Both <br /># <br />Code Section <br />VIOLATIONS) HSC=California Health & Safety Code; CCR=California Code of Regulations <br />V=Violation; RV=Re eat Violation <br />V R <br />V <br />1 <br />HSC 25284 <br />Permit tooperate <br />2. <br />CCR 2637 <br />Secondn containment test performed <br />3 <br />CCR 2711 & 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 c 2 D <br />Monitoring & res onse plan is current and filed with the local a enc <br />6' <br />CCR 2712 .1) <br />Monitvrin ',& res onse Rlan is onsite <br />7 <br />CCR 2712 b <br />Maintenance & monitoring records <br />l <br />8' <br />CCR 2643 d <br />Daily tnonitorinj of suction pipinrS:JanuM, 1, 1984 <br />9 <br />HSC 25292.1 <br />UST system isoperated to grevent unauthorized release <br />10 <br />CCR 2632 (c)(2) <br />UST monitoring s stem is present <br />Ml <br />I I <br />CCR 2630 d <br />UST system monitoring equipment is pro2erly located to detect a leak <br />l <br />12 <br />HSC 25291 <br />UST s stem monitoring e4uipment isoperational <br />M2 <br />13 <br />CCR 2636 1 <br />Continuous monitoring system for underground piping & UDC is present <br />Ml <br />14 <br />CCR 2631 a <br />Primary containment is product tight <br />15 <br />HSC 25291 a)(2) <br />Secondary containment for UST is tight <br />16 <br />17 <br />CCR 2636 (c)(1) <br />HSC 25291 <br />All releases in secondary Ri:Ring flow to a collection sum <br />Line leak detectors are installed <br />Ml <br />18 <br />19 <br />CCR 2635 i <br />CCR 2635 2 <br />Spill container <br />Overfill 2revention system <br />M2 <br />M2 <br />20 <br />CCR 2636',(a) <br />Conventional suction i in ''shall have continuous monitoring '& 2° containment <br />21 <br />HSC 25291 (e) <br />Water in 2° containment analyzed & properly disposed of <br />22 <br />CCR 2650 <br />Recordin re2orting of unauthorized releases <br />M1 <br />23 <br />CCR 2715 <br />Designated 0 erator: (a2 Statement from UST owner; (c -e) MonthIX ins ection; f) Employee training <br />24 <br />CCR2638' a <br />Annual monitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test <br />Ml <br />26 <br />HSC 25284.2 <br />Annual spill containartent=testirt <br />27 <br />CCR 2636 4 <br />Annual line tightness test <br />Ml <br />28 <br />CCR 2661 <br />Re'' air fast tankl i in has had tightness test <br />M2 <br />29 <br />CCR 2643 e <br />Biennial ti htness test of aviY i in re -Jana 1, 1984 <br />30 <br />CCR 2643 d <br />Triennial line test for conventional suction pj in re-Janu 1, 1984 <br />1 <br />31 <br />HSC 25292.5 <br />Double walls stem located within 1000' of 2ublic well-ELD <br />32 <br />CCR 2661 <br />Permit to r air UST system <br />, <br />33 <br />HSC 25286 a <br />Permit to alter monitoring system <br />34 <br />HSC 25298 <br />Permit to temporarily close USTs stemm <br />35 <br />HSC 25298 c <br />Permit to close UST system <br />36 <br />HSC 25299 a 9 <br />Disabling leak detection devices <br />37 <br />HSC 25298 a <br />Illegal abandonment of UST system <br />38 <br />Other: <br />EHD INSPECTOR: <br />PHONE: <br />UIC <br />Septic system: <br />❑ Serves >_20 people/day <br />❑ Receives other than sanitary waste <br />Other disposal methods: <br />❑ Dry wells/French Drains <br />RECEIVED BY: TITLE: <br />E14D 23-02-002 <br />