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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sivov.orp-/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> �Affi\/ I 'gqwda F4atlrtf CWS ---- — <br /> Facility address: UST# <br /> 2-o-" �&-nmp�opa kom Ck-M A f Product <br /> Facility Contact: Title: Phone: <br /> poeAV iL (4F� - <br /> 61KI 20' 1--,- <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> Ala Sn fAL Vressurized F-1 Suction 0 Gravity echanical D Audible/visual <br /> Inspection type: Violations: <br /> li?koutine W4onitoring Certification El Installation 11 Other: [I M I-RDetect El M2-RPrev 11 M-3 Both <br /> # Code Section VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=California Code of Regulations V R <br /> V=Violation;RV=R2eat Violation V <br /> I HSC 25284 Permit tooperate <br /> 2 CCR 2637 Seconds containment test performed <br /> 3 CCR 2711 (b)&(c) Current Unified Program Consolidated Forms on file with EHD(Facility and tank form) <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632(b) Monitoring Pro am Monitoring&Res once Plan)is current and approved by the local agenc <br /> 6 CCR 2712(i) Monitoring plan is onsite. <br /> 7 CCR 2712(bMaintenance&monitorinrecords (Ml)___ <br /> 8 CCR 2643(d) Daily n nitotnMof suction i in re-Janusa, 1, 1984) <br /> 9 1 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632 c)(2) UST monitoring sXstem is 2resent (Ml) <br /> I I CCR 2630 d) UST system monitorinegui2ment is 2ro2erly located to detect a leak (MI) <br /> 12 HSC 25291 b UST s stem monitorinLEg=nt isoperational (M2) <br /> 13 CCR 2636(f)(1) Continuous monitoring system for underground piping&UDC is present 1) <br /> 14 CCR 2631 (a) Primary containment is 2roduct tight <br /> 15 HSC 25291 (a 22 Secondary containment for UST is ti ht <br /> 16 CCR 2636 1c)(1) All releases in seconds 2iping flow to a collection sum <br /> 17 HSC 25291 Line leak detectors)are installed <br /> 18 CCR 2635 b) 1) Spill container (M2) <br /> 19 CCR 2635(b)(2) Overfill 2revention system (M2) <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2'containment <br /> 21 HSC 25291 (e) Water in 2'cont <br /> 22 CCR 2650 Recordin&/rMortinof unauthorized releases (M 1) <br /> 23 CCR 2715 Designated 02erator:(a)Statement from UST owner; (c-e)Monthly insgection; f)Em to ee trainin � V <br /> 24 CCR 2638(aAnnual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (M 1) <br /> 26 HSC 25284.2 Annual s2ill containment testinE <br /> 27 CCR 2636 D 4) Annual line tightness test (M1) <br /> 28 CCR 2661 (f) Repair for tank/2i2ing has had tihtness test (M2) <br /> 29 CCR 2643(el Biennial tiZhtncss test of gravity piping(pre-January 1, 1984) <br /> 30 CCR 2643(d) Triennial line test for conventional suction 2ieinre-Janus a 1, 1984) (Ml)_ <br /> 31 HSC 25292.5 Double walls stem located within 1000'of gublic well-ELD <br /> 32 CCR 2661 Permit to re air UST system <br /> 33 1 HSC 25286(a) Pen-nit to alter monitoring system <br /> 34 1 HSC 25298(b) Permit to tem2orarily close UST system <br /> 35 HSC 25298(c) Permit to close UST system <br /> 36 HSC 25299(a)(9) Disabling leak detection devices <br /> 37 HSC 25298 a) Illegal abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> L)ol Septic sm: <br /> 9-M !±& ysteK— 10-1� , .— -Serves��20 people/day <br /> RECEIVED Y: TITLE: -Receives other than sanitary waste <br /> Other disposal methods: <br /> Dry wells/French Drains <br /> a <br /> U <br /> EHD 23-02-002 REV 05/07 <br />