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SAN JOAQUIN COUNTY <br /> 9NVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street,Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fav(209)468-3433 Web:www.sigov.orgLe <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INS CTI REPORT <br /> Facility name: Designated0Operator: Inspection Date: <br /> 1.1 <br /> 0vmm <br /> Facility address: UST# <br /> Product <br /> Facility Contact: Title: Phone: <br /> eJ 01/S1 <br /> i orpg ane: Piping system: Overfill prevention: <br /> qrk 'I LA-7 _760 I Suction 0 Gravity 0 Mechanical Audible/visual <br /> Monitor' Panel: 0 Pressurized M/ <br /> IVpection type- I <br /> IRoutine &onitoring Certification 0 Installation 0 Other: 0 M I-RDetect El M2-RPrev 0 M-3 Both <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section V <br /> V=Violation;RV=Repeat Violation <br /> I HSC 25284 Permit too erste <br /> 2 CCR 2637 Second 2a containment test 2erformed <br /> 3 CCR 2711 (b)&(c) Current Unified Pro am Consolidated Forms on file with EHD(Facility and tank form) <br /> 4 HSC 25292.2 Certification of financial responsibili!y and CFO letter <br /> 5 CCR 2632(b) MonitorinPro am(MonitorinE&Response Plan)is current and Nproved by the local agency. <br /> 6 CCR 2712(i) Monitoring plan is onsite. <br /> 7 CCR 2712(b) Maintenance&monitoring records (MiF <br /> 8 CCR 2643(d) 2±!=itorinof suction piping(pre-January, 1, 1984) <br /> 9 HSC 25292.1 UST system_iso erated to revent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring astern is 2resent (Mi) <br /> 11 CCR 2630(d) UST system monitoning equipment is properly located to detect a leak (Mi) <br /> 12FHSC 25291 (b) UST system monitoring atti ment isoperational (M2) <br /> 13 CCR 2636(f)(1) Continuous monitoring system for underground piping&UDC is present (MI) <br /> I I --in-7m—ary containment is product tight <br /> 4 CCR 2631 (a) <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 263,11,6�0 All releases in second i in flow to a collection sum <br /> 17 HSC 25291 (f) Line leak detector s)are installed (Mi) <br /> _18 CCR 2635(b)(1) Spill container (M2) <br /> 19 CCR 2635(b)(2) _2y2±E2MLntion s stem (M2) <br /> 20 CCR 2636(a) Conventional suction pipinshall have continuous monitoring&2'containment <br /> il HSC 25291 (e) Water in 2'containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases (Mi) <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly ins ection;(f)Employee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (Mi) <br /> 26 HSC 25284.2 Annual Spill containment testing <br /> 27 1 CCR 2636(f)(4) Annual line tightness test (Mi) <br /> _28j CCR 2661 (f) RSpair for tank/ i,in,has had tightness test (M2) <br /> 29 CCR 2643(e) Biennial ti htness test of avit i in re-Janusry 1, 1984) <br /> 30 CCR 2643(d) Triennial line test for conventional suction Eiping(pre-January 1, 1984) (Mi) <br /> 31 HSC 25292.5 Double wall system located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to LTair UST system <br /> 33 HSC 25286 a).. Permit to alter monitoring system <br /> 34 HSC 25298(b) Permit to temorarily close UST system <br /> 35 HSC 25298(c) Permit to close UST system <br /> 36 1 HSC 25299(a)(9) DisablinE leak detection devices <br /> 37 HSC 25298(a) Illegal abandonment of UST system <br /> 38 Other: <br /> 4 E DIN PECTOR PHONE: UIC <br /> Vat 1101) Sotic Ustem: <br /> DIN <br /> 04 1 -Serves�!20 people/day <br /> REC D TITLE: E-21 Receives other than sanitary waste <br /> _jdisposal methods: <br /> wells 'h <br /> Drains <br /> EHD 23-02-002 REV 05/07 <br />