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1/7 SAN JOAQUIN COUN* <br />ENvIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3dFloor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax.- (209) 464-0138 Web: www.sjgov.org/ehd <br /># <br />UINDEKUKULIND NOKAGE -FAN(UST) PROGRAM <br />INSPECTION "PORT <br />Facility name: <br />HSC 25284 <br />Designated Operator: Inspection Date - <br />Facility address: <br />2 <br />UST# <br />Secondary containment test rformed <br />Product <br />Facititv Contact-, <br />Title: Phone: <br />and tank form) <br />Monitoring Panel: <br />J-Pil-p—i-9 <br />System: <br />Overfill prevention: <br />5 <br />CCR 2632 (c)(2)(D) <br />&Pressurized 0 Suction 0 Gravity <br />aMcchanical F-3 Audiblelvisual <br />.. �ectlon type: <br />CCR 2712 (i) <br />Violations: <br />PIZsp <br />I o'Routine <br />0, Monitoring Certification U Installation 0 Other: <br />0 M I -R-Detect 11 M2-RPrev D M-3 Boll <br /># <br />Code Section <br />I <br />VIOLATION(S) HSC=Califomia Health & Safety Code; CCR=Califomia Code of Regulations V <br />V=Violation. RV=Repeat Violation <br />I <br />HSC 25284 <br />Permit to operate <br />2 <br />CCR 2637 <br />Secondary containment test rformed <br />3 <br />CCR 2711 (b) & (c) <br />Current Unified Program Consolidated Forms on file with EHD (Facility <br />and tank form) <br />4 <br />HSC 25292.2 <br />Certification of financial res22nsibili!y and CFO letter <br />5 <br />CCR 2632 (c)(2)(D) <br />_Monitoring & response plan is current and filed with the local agency <br />6 <br />CCR 2712 (i) <br />MonitorinE & reT2nse plan is onsite <br />7 <br />CCR 2712 (b) <br />Maintenance & monitorinrecords <br />(MI) <br />8 <br />CCR 2643 (d) <br />Daily monitorinof suction pi2ing (pre -January, 1, 1984) <br />9 <br />HSC 25292.1 <br />UST system isoErated to prevent unauthorized release <br />10 <br />CCR 2632 (c)(2) <br />UST rrtonitorinsystem is present <br />(MI) I <br />I I <br />CCR 2630 (d) <br />UST system monitofinuipment is proeerly located to detect a leak <br />(MI) <br />12 <br />HSC 25291 (b) <br />UST system monitoripj 2guipment iso rational <br />(M2) <br />13 <br />CCR 2636 (f)(1) <br />Continuous monitoring system for underground piping & UDC is present <br />(MI) <br />14 <br />CCR 2631 (a) <br />Primary containment is 2roduct ti ht <br />15 <br />HSC 25291 (a)(2) <br />Second 2g containment for UST is tight <br />16 <br />CCR 2636 (c)(1) <br />All releases in seconds _Riping, flow to a collection sume <br />17 <br />HSC 25291 (f) <br />Line leak detector(s) are installed <br />(MI) <br />IS <br />CCR 2635 (]) <br />Seill container <br />(M2) <br />19 <br />CCR 2635 (b)(2) <br />Overfill erevention 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 2' containment analyzed & properly disposed of <br />22 <br />CCR 2650 <br />Recording/reporting of unauthorized releases <br />(MI) <br />23 <br />CCR 2715 <br />DesiEnated Operator: (a) Statement from UST owner; (c -e) Monthly inspwicin; <br />(f) Em2loyee training <br />24 <br />CCR 2638 (a) <br />Annual monitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test <br />(MI) <br />26 <br />HSC 25284.2 <br />Annual spill containment testing <br />27 <br />CCR 2636 (f)(4) <br />Annual line tightness test <br />(MI) <br />28 <br />CCR 2661 (f) <br />Repair for tank/piping has had tir, <br />,�mess test <br />(M2) <br />29 <br />CCR 2643 (e) <br />Biennial tightness test of ravity piping (re -Janus !j 1, 1984) <br />30 <br />CCR 2643 (d) <br />Triennial line test for conventional suction pieinE (re -Janus 1, 1984) <br />(MI) <br />31 <br />HSC 25292.5 <br />Double-wall system located within 1000' of public well-ELD <br />32 <br />CCR 2661 <br />Permit to Le air UST system <br />1 <br />33 <br />HSC 25286 (a) <br />Pen -nit to alter monitorinsystem <br />34 <br />HSC 25298 (b) <br />Permit to teme2rarily close UST system <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 />lllcal abandonment of UST system <br />38 <br />Other: <br />EHD INSPECTOR: <br />[7EI�E>� BY.- <br />PHONE* <br />TITLE: <br />UIC <br />Septic System: <br />3 Serves >20 people/day <br />Ci Receives other than sanitary waste <br />Other djsgosal methods: <br />Dry wells/French Drains <br />FfID 23-02 <br />1 19 In, <br />