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• SAN JOA UI COUNTY <br />RONMENTAL HEALTH DEPARTMENT 16 <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax.- (209) 468-3433 Web: v.org/ehd <br /># <br />Code Section <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=Califomia Code of Regulations v V <br />V=Violation; RV=Reat Violation <br />I <br />HSC 25284 <br />Permit too erate <br />Facility address: <br />2 <br />CCR 2637 <br />Secondcontainment test performed <br />3 — <br />I L <br />Current Unified Program 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 />Facility Contact: <br />Title: <br />Phone: <br />the local Mency. <br />6 <br />CCR 2712 (i) <br />1110 A0144-- <br />Vivo V�(eriiiipre;ention: <br />7 <br />( <br />Maintenance& monitoriii records <br />(MI) <br />P,ng <br />system: <br />Daily monitoring of suction piping (pre -January, 1, 1984) <br />9 <br />HSC 25292.1 <br />�kr 10 <br />;Csurized Suction <br />D Gravity <br />Mechanical <br />El Audib lelvisual <br />ection type* <br />P' <br />-Fl <br />CCR 2630 (d) <br />UST I S, stem monitorin e ui ment is properly located to detect a leak <br />(Ml) <br />12 <br />rn <br />Routine 4onitoring <br />Certification 0 installation <br />0 Other: <br />73 <br />CCR 2636 1 <br />_L����cquipment <br />Continuous m <br /># <br />Code Section <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=Califomia Code of Regulations v V <br />V=Violation; RV=Reat Violation <br />I <br />HSC 25284 <br />Permit too erate <br />2 <br />CCR 2637 <br />Secondcontainment test performed <br />3 — <br />-CCR 2711 (b) & (c) <br />Current Unified Program 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 />-3-- <br />CCR 2632 (b) <br />Monitotpy,. Program (Monit2)trinn&&�Rese Plan) is current and a. . roved b- <br />the local Mency. <br />6 <br />CCR 2712 (i) <br />Monitoring 21an is onsite. <br />7 <br />( <br />Maintenance& monitoriii records <br />(MI) <br />8 <br />CCR 2643 (d) <br />Daily monitoring of suction piping (pre -January, 1, 1984) <br />9 <br />HSC 25292.1 <br />s stem iso stated to revent unauthorized release <br />"1-0 <br />CCR 2632 (c)(2) <br />_UST <br />UST morI system is 2resent <br />(MI) <br />-Fl <br />CCR 2630 (d) <br />UST I S, stem monitorin e ui ment is properly located to detect a leak <br />(Ml) <br />12 <br />HSC 25291 (b) <br />UST stem monitori isoperational <br />(M2) <br />73 <br />CCR 2636 1 <br />_L����cquipment <br />Continuous m <br />14 <br />2631 (a) <br />Prima containment is roduct ti ht <br />15 <br />-CCR <br />HSC 25291 (a)(2) <br />Seconda containment for UST is tight <br />CCR 2636 (c)(12_ <br />All releases in secondary 2ipinE flow to a collection sump <br />17 <br />HSC 25291 (f) <br />Line leak <br />(Mi) <br />18 <br />CCR 2635 (b)(1) <br />S2ill container <br />(M2) <br />19 <br />CCR 2635 (b)(2)_ <br />Overfill pLevention system <br />(M2) <br />OF6 <br />2 0 <br />CCR 2636 (a) <br />Conventional �suctio �iing shall have continuous monitoring & 2' containment <br />21 <br />HSC 25291 (e) <br />Water in 2' containment analyzed &pro erly disposed of <br />22-- <br />CCR 2650 <br />RecordinaLrMorting of unauthorized releases <br />(MI) <br />23 <br />CCR 2715 <br />Designated Operator: (a) Statement from UST owner; (c -e) Monthly ins ection; (f) Employee training <br />24 <br />1 <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 />Annuals ill containment testin <br />27 <br />Annual line tigttness test <br />(Mi) <br />28 <br />CCR 2661 (f) <br />R air for tank/-:-:- has had ti2htness test <br />(M2) <br />2-91 <br />CCR 2643 (e) <br />Biennial tightness test of Eavity piping (pre -January 1, 1984) <br />30--1 <br />CCR 2643 (d) <br />Triennial line test for convcntiona�c)n�iping (pre -Jana M 1, 1984) <br />(Mi) <br />' <br />HSC 25292.5 <br />Double wallsystem located within 1000' of public well-ELD <br />32 <br />CCR 2661 <br />n_ <br />Permit to air UST system <br />33 <br />[3 <br />HSC 25286 (a) <br />Permit to alter monitorinji �s stem <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 (a)(9) <br />Disabling leak detection devices <br />37 <br />HSC 25298 (a) <br />Illegal abandonment of UST system <br />---TOther: <br />—38 <br />F E OR: <br />W INS <br />Ifta RN I <br />I <br />RECEIVED BV: <br />PHONE: <br />uto q) /®, /� <br />TITLE:' <br />ykvv-� <br />UIC <br />Septic system: <br />-] Serves >_10 people/day <br />711 Receives other than sanitary waste <br />Other disposal methods: <br />7 Dry wells/French Drains <br />EHD 23-02-002 REV 05/07 <br />