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SAN JOAQUIN COUNTY <br /> _NVIRONMENTAL HEALTH DEPARTMENT <br /> 6010ast Main Street,Stockton,California 95202-3021 <br /> Telephone:(209)468-3420 Fax. (209)468-3433 Web:www.sjgov.org/e <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> -Facility name: Designated Operator: Inspection Date: <br /> I-11 <br /> Facility address: UST# <br /> 11 <br /> N -T-124" PAA10 'Product <br /> 7_7 7 <br /> Facility Contact: Title: hone: <br /> M <br /> Vitoring Panel: Piping system: Overfill prevention: <br /> 2Eessurized 0 Suction E Gravity b6lechanical El Audible/visual <br /> Inspection type: Violations: <br /> t(Routine onitoring Certification 11 Installation El Other: El M I-RDetect [I M2-RPrev El M-3 Both <br /> I VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section V=Violation;RV=R2eat Violation V <br /> I HSC 25284 Permit too erste <br /> 2 CCR 2637 Secondary containment test performed A. <br /> 13 CCR 2711 (b)&(c) Current Unified Program-Consolidated Forms on file with EFID(Facility and tank form) <br /> 4 HSC 25292.2 Certification of financial responsibili!y and CFO letter <br /> F 5 CCR 2632�b) Monitoring Pro am(Monitoring&Response Plan)is current and approved by the local Mency. <br /> 6 CCR 2712(i) Monitoring plan is onsite. W01, <br /> 7 CCR 2712(b) Maintenance&monitoring records �Ml) <br /> 8 CCR 2643(d) Daily monitoring of suction gipinE( n <br /> pre-Jami , 1, 1984) <br /> 9 HSC 25292.1 UST s stem iso erated to revent unauthorized release <br /> 10 CCR 2632 c)( UST monitori2L-Lsystem is 2resent (Mi) <br /> I I CCR 2630(d) UST system mon±to�rine ui�ment is located to detect a leak (Mi) <br /> 12 HSC 25291 (b) UST system monitoring e ui ment is (M2) <br /> 13 CCR 2636 1) Continuous monitorin s stem for under ound i in &UDC is resent Mi) <br /> 14 CCR 2631 (a) Prim containment is product tight <br /> 15 <br /> HSC 25291 a) 2) Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) ;ill-releases in seconds ]gi2ing flow to a collection sump <br /> 17 HSC 25291 (f) Line leak detector(s)are installed (Mi) <br /> 18 CCR 2635(b)(1) Spill container (M2) <br /> 79 CCR 2635(b)(2) Overfill prevention system (M2) <br /> 20 CCR 2636(a) Conventional suction iping shall have continuous monitoring&2'containment <br /> _21 HSC 25291 (e) Water in 2'containment analyzed&properly disposed o <br /> 22 CCR 2650 Recordin reporting of unauthorized releases (Mi) <br /> 23 CCR 2715 Designated 22erator:(a)Statement from UST owner; (c-e)Monthly inspection;(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 CCR 2636(9(4) Annual line tightness test (MI) <br /> 28__CCR 2661 (f) Repair for tank/,i,in.has had tightness test (M2) 1 1 <br /> 29 CCR 2643(e) Biennial tightness test of Eavity pi2ing(pre-January 1, 1984) <br /> [30 1 CCR 2643�d) Triennial line test for conventional suction 12iging(pre-January 1, 1984) (Mi) <br /> 31 HSC 25292.5 Double wall system located within 1000'of public well-ELD V, <br /> 32 CCR 2661 Permit to Lepair 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(a)(9) Disabling leak detection devices <br /> 37 1 HSC 25298 a) Illegal abandonment of UST system /9 <br /> 38._ Other: UIC <br /> Rt I A A <br /> Septic system: <br /> EMK - <br /> I IN Serves�:20 people/day <br /> TI E: [7,Receives other than sanitary waste <br /> RECEIVED BY: Other disposal methods: <br /> wells/French Drains <br /> EHD 23-02-002 REV 05/07 <br />