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SAN JOAQUIN COUNTY <br />NVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, California 95202 29 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.orq/ehd <br />IINnFRGRO11ND STORAGE TANK (USTI PROGRAM INSPECTION REPORT <br />Facility name: Designated Operator: <br />�W4 � )Z-fib®i <br />Inspection <br />Date: <br />pection type: Violations: <br />outine onitoring Certification 0 Installation 0 Other: 0 M1-RDetect <br />rS <br />0 M2-RPrev 0 M-3 Both <br />Facility address: UST <br />'Product <br />Code Section <br />i <br />1 <br />Facility Contact: Title: Phone: <br />Permit tooperate <br />2 <br />nitoling Panel: <br />Piping system: vvc111n plaeclluve..j ressurized 0 Suction 0 Gravi echanical 0 Audible/visual <br />pection type: Violations: <br />outine onitoring Certification 0 Installation 0 Other: 0 M1-RDetect <br />rS <br />0 M2-RPrev 0 M-3 Both <br /># <br />Code Section <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=Califomia Code of Regulations V R <br />V <br />V=Violation; RV=Re eat Violation <br />1 <br />HSC 25284 <br />Permit tooperate <br />2 <br />CCR 2637 <br />y containment test performed ( ° <br />Secondar <br />If <br />3 <br />CCR 2711 b & c <br />Current Unified Program Consolidated Forms on file with EHD(Facility tank form <br />® 4 <br />HSC 25292.2 <br />Certification of financial responsibility and CFO letteri< <br />5 <br />CCR 2632 b <br />Monitoring Program(Monitoring & Response Plan is current and approved by <br />the local agency.aK <br />6 <br />CCR 2712 i <br />Monitoring plan is onsite.it <br />w 7 <br />CCR 2712 b <br />Maintenance & monitoring records <br />M1 <br />8 <br />1 CCR 2643 (dj <br />Daily monitoring of suction piping (pre -January, 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 monitorings stem is present <br />M1 <br />11 <br />CCR 2630 d <br />UST system monitoring equipment is properly located to detect a leak <br />M1 <br />12 <br />HSC 25291 b <br />UST system monitoring equipment isoperational <br />M1 <br />13 <br />CCR 2636 1 <br />Continuous monitoring system for underground eiping & UDC is present <br />M1 <br />14 <br />CCR 2631 a <br />Primary containment is product fight <br />® 15 <br />HSC 25291 (a)(2) <br />Seconda containment for UST is tight <br />16 <br />CCR 2636 (c)(1) <br />All releases in seconds piping flow to a collection sum <br />17-• <br />NSC 25291 <br />Line leak detectors are installed <br />M1 <br />® 18 <br />CCR 2635 (b)(1) <br />Spill container <br />M2 <br />19 <br />CCR 2635 b 2 <br />Overfill prevention system <br />10112 <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 20 containment <br />21 <br />HSC 25291 (e) <br />water in 20 containment analyzed & properly disposed of <br />® 22 <br />CCR 2650 <br />Recording/reportingg of unauthorized releases <br />M1 <br />a 23 <br />CCR 2715 <br />Designated Operator: a Statement from UST owner; c -e Monthly inspe Em to ee trainin <br />a 24 <br />CCR 2638 a <br />Annual monitoring certificatio <br />_ <br />® 25 <br />CCR 2638 a <br />Annual line leak detector test <br />M1 <br />a 26 <br />HSC 25284.2 <br />Annual spill containment testing <br />27 <br />CCR 2636 4 <br />Annual line tightness test <br />M1 <br />28 <br />CCR 2661 <br />Repair for tank/piping has had tightness test <br />(M2 <br />29 <br />CCR 2643 a <br />Biennial tightness test of gravity pipingre-Janus 1, 1984 <br />30 <br />CCR 2643 d <br />Triennial line test for conventional suction piping pre -Janus 1, 1984) <br />(M1 <br />31 <br />HSC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <br />32 <br />CCR 2661 <br />Permit to repair UST system <br />33 <br />HSC 25286 a <br />Permit to alter monitoring system <br />34 <br />HSC 25298 b <br />Permit to temporarily close UST system <br />35 <br />HSC 25298 c <br />Permit to close UST system <br />36 <br />HSC 25299 <br />a A 2 <br />Disabling leak detection devices <br />37 <br />HSC 25298 a <br />lile al abandonment of UST system <br />38 <br />Other: <br />EHD INSPE TOR: <br />Aftak <br />PHONE: <br />, <br />UIC <br />Septic system: <br />❑ Serves >_20 people/day <br />0 Receives other than sanitary waste <br />Other disposal methods: <br />0 Dry wells/French Drains <br />RECENE YTITLE: <br />P <br />® <br />EHD 23-02-002 REV 8/08 <br />