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SAN JOA UIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, California 95202-3029 <br /> Telephone: (209) 468-3420 Fax:(209)468-3433 eb: .sjgov.or /� ehd <br /> UNDERGROUND STORAGE T INSPECTION REPORT <br /> Facility name:C De nated Operator: Inspection/ <br /> 'W n r, <br /> Facility address: UST# <br /> .'Oroduct 1 <br /> Facility Contact: Title: Phone: <br /> Monitoring Panel: _ Piping system: Overfill prevention: <br /> ressurized ❑Suction ❑Gravi Mechanical ❑Audible/visual <br /> Inspection type: Violations: <br /> outine Monitoring Certification ❑Installation ❑Other: ❑M1-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V R <br /> Code Section V <br /> V=Violation; RV=Re eat Violation <br /> HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondarycontainment test performed <br /> 3 <br /> 1FCCR 2711 b & c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br /> HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 b Monitorin Pro ram Monitorin &Res onse Plan is current and a roved b the local a enc . <br /> 6 CCR 2712 i Monitoring Ian is onsite. <br /> 7 CCR 2712 b Maintenance&monitoring records 1 <br /> 8 CCR 2643 d Daily monitoring of suction piping (pre-January, 1, 1984 <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present 1 <br /> 11 CCR 2630 d UST system monitoring equipment is properly located to detect a leak M1 <br /> 12 HSC 25291 b UST system monitoring equipment isoperational M1 <br /> 13 CCR 2636 1 Continuous monitorin2 system for underground 2iping&UDC is present M1 <br /> 14 CCR 2631 (a)__ Prima containment is product tight <br /> 15 HSC 25291 (a)(2)_ Seconda containment for UST is tight_____ <br /> 16 CCR 2636(c)(1) All releases in secondary E!2!n flow to a collection sum <br /> 17 HSC 25291 Line leak detectors are installed M1 <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&20 containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases M1 <br /> 23 CCR 2715 Designated Operator: a Statement from UST owner; (c-e)Monthly inspection; Employee trainin <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638 a Annual line leak detector test M1 <br /> 26 HSC 25284.2 Annuals ill containment testin <br /> 27 CCR 2636 4 Annual line tightness test 1 <br /> 28 CCR 2661 Re air for tank/piping has had tightness.test 2 <br /> 29 CCR 2643 a Biennial ti htness test of qravity piping(pre-January 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping(pre-January1, 1984 1 <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 34 HSC 25298 b Permit to temporarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299 Disabling leak detection devices <br /> a 9 2 <br /> 37 HSC 25298 a Ille al abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR PHONE: UIC <br /> /L h Septic system: <br /> "7 ✓ CI Serves>_20 people/day <br /> R E E B T TLE: ❑Receives other than sanitary waste <br /> ther disposal methods: <br /> ❑Da wells/French Drains <br /> EHD 23-02-002 REV 8/08 <br />