Laserfiche WebLink
13 <br />"t <br />0 SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPAR ENT <br />304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />Facility name: <br />Code Section <br />Designated Operator: Inspection Date: <br />0('%'y V1 F'1 W Ci l L- <br />HSC 25284 <br />(� lLZl!5�OM 60l°P <br />Facility <br />2 <br />UST #'I-' <br />Secondary containment test performed <br />/address: (� <br />�/►/�roduct <br />I I G I��%I� <br />3 <br />P <br />n <br />Facility Contact: Title: <br />Phone: <br />Certification of financial responsibility and CFO letter <br />5 <br />� 1 <br />to 1W® <br />Monitoring & response plan is current and filed with the local agency <br />✓ <br />Monitoring Panel: <br />Piping system: <br />Nofressurized ❑ Suction <br />❑ Gravity <br />Overfill prevention: <br />echanical ❑ Audible/visual <br />Inspection type: <br />CCR 2712 (b) <br />Violations: <br />�,11 <br />3 outine L�Ylvlonitorin Certification ❑ Installation <br />❑ Other: <br />❑ MI-RDetect ❑ M2-RPrev ❑ M-3 Both <br /># <br />Code Section <br />VIOLATIONS) HSC=California Health & Safety Code; CCR=California Code of Regulations 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 ram 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 & response plan is current and filed with the local agency <br />✓ <br />6 <br />CCR 2712 i <br />Monitoring & response plan is onsite <br />7 <br />CCR 2712 (b) <br />Maintenance & monitoring records <br />(Ml) <br />8 <br />CCR 2643 d <br />Daily monitoring of suction piRing (re-Janua , 1, 1984 <br />9 <br />HSC 25292.1 <br />UST system isoperated to prevent unauthorized release <br />10 <br />CCR 2632 (c)(2) <br />UST monitoring system is present <br />Ml <br />11 <br />12 <br />CCR 2630 (d) <br />HSC 25291 b <br />UST system monitoring equipment is 2ro2erly located to detect a leak <br />UST system monitoring equipment isoperational <br />(Ml) <br />(2 <br />13 <br />CCR 2636 (f)(1) <br />Continuous monitorin s stem for under ound i in &UDC is resent <br />(l) <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 />CCR 2636 (c)(1) <br />All releases in secondary piRing flow to a collection sum <br />17 <br />18 <br />HSC 25291 (f) <br />CCR 2635 (b)(1) <br />Line leak detector(s) are installed <br />Spill container <br />(Ml) <br />M2 <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system <br />(M2) <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 2° containment <br />21 <br />HSC 25291 (e) <br />Water in 21 containment analyzed & pro2erly disposed of <br />22 <br />CCR 2650 <br />Recording/reporting of unauthorized releases <br />Ml <br />23 <br />CCR 2715 <br />Designated Operator: (a) Statement from UST owner; (c -e) Monthly inspection; f) Em loyee training <br />24 <br />25 <br />CCR 2638 (a) <br />CCR 2638 (a) <br />Annual monitoring certification <br />Annual line leak detector test <br />(Ml) <br />26 <br />HSC 25284.2 <br />Annuals ill containment testing <br />27 <br />28 <br />CCR 2636 (f)(4) <br />CCR 2661 <br />Annual line tightness test <br />Repair for tank/piping has had ti htness test <br />(Mi) <br />M2 <br />29 <br />30 <br />CCR 2643 (e) <br />CCR 2643 (d) <br />Biennial tightness test of gravity piping (re -Januar 1, 1984) <br />Triennial line test for conventional suction pi2ing (2re-January1, 1984) <br />Ml <br />31 <br />32 <br />HSC 25292.5 <br />CCR 2661 <br />Double wall system located within 1000' of public well-ELD <br />Permit to repair UST system <br />33 <br />HSC 25286 (a) <br />Permit to alter monitorinE system <br />34 <br />HSC 25298 (b) <br />Permit to tem oraril close UST s stem <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 />IBY: <br />7,,.Vs ® <br />PHONE: <br />TITLE: <br />�n,n`/s� A s.ar / �d,..__ AZ � r <br />UIC <br />Septic system: <br />❑Serves >_20 people/day <br />❑ Receives other than sanitary waste <br />Other disnosal methods: <br />❑ Dry wells/French Drains <br />EHD 23-02 <br />1 PA /07 <br />