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6 SAN JOAQUIN COUNTY 0 <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: w-ww.sjgov.org/ehd <br />it 1@1113-6121191111' i I Poll! III'! I I 111111111,11 � � I �ii 11 <br />Facility name: <br />Designated Operator: <br />Inspection Date: <br />Facility address: <br />- 13 + L <br />UST # <br />Product <br />Facility Contact: Title: Phone: <br />t) r t f k-, <br />Monitoring Panel: <br />V -X T -L-5 7,5; O� <br />Piping system: <br />1 0 Pressurized Itesaction El Gravity <br />Overfill prevention: <br />&Mechanical El Audible/visual <br />Inspection type: <br />X�outine Avonitoring <br /># Code Section <br />I Violations: <br />Certification El Installation El Other: D MI-RDetect El M2-RPrev <br />VIOLATION(S) HSC=Califomia Health & Safety Code; CCR=Califomia Code of Regulations <br />V=Violation; RV=RF2eat Violation <br />El M-3 Both <br />V R <br />V <br />I <br />HSC 25284 <br />Permit tooperate <br />2 <br />CCR 2637 <br />Secondaa containment test 2erfortned <br />3 <br />CCR 2711 (b) & (c) <br />Current Unified Pro gram.Consolidated Forms on file with EHD ffacility and tank form) <br />4 <br />HSC 25292.2 <br />Certification of financial res2onsibility and CFO letter <br />5 <br />CCR 2632 b <br />Monitoring Proram Monitoring & Res2onse Plan) is current 2proved by the 12SLIa enc . <br />6 <br />CCR 2712 (i) <br />Monitorim 2Ian is onsite. <br />7 <br />CCR 2712 b) <br />Maintenance & monitoring records <br />(M1) <br />8 <br />9 <br />CCR 2643 (d) <br />HSC 25292.1 <br />Daily monitoring of suction 2ipinre-Janusa, 1, 1984) <br />UST system iso2erated to prevent unauthorized release <br />to <br />11 <br />12 <br />-CCR 2632 (c)(2) <br />CCR 2630 d) <br />HSC 25291 b) <br />UST monitorinZ system is 2resent <br />UST system monitoring equipment is properly located to detect a leak <br />UST system monitorin 7, ec ment is --tional <br />(M1) <br />(M1) <br />(M2) <br />13 <br />14 <br />CCR 2636 (DI 1) <br />CCR 2631 1a) <br />Continuous monitoring system for underground i2inE & UDC is resent <br />Primary containment is 2roduct tiht <br />(Ml� <br />15 <br />HSC 25291 (a)(2) <br />SecondaEZ containment for UST is ti ht <br />16 <br />CCR 2636 (c)(1) <br />All releases in secondary piping flow to a collection sum2 <br />17 <br />HSC 25291 (f) <br />Line leak detectors ) are installed <br />1) <br />18 <br />CCR 2635 (bI) <br />S2ill container <br />(M2) <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system <br />(M2) <br />20 <br />21 <br />CCR 2636 (a) <br />HSC 25291 (e) <br />Conventional suction 2i2ing shall have continuous monitorin& 2' containment <br />Water in 2' containment analyzed & 13ro2erly disposed of <br />22 <br />CCR 2650 <br />Recordin/re 2ortinZ of unauthorized releases <br />(M1) <br />23 <br />CCR 2715 <br />Desinated 02erator: (a) Statement from UST owner; (c -e) Monthly ins2ection; f) Employee trami <br />24 <br />CCR 2638 a2 <br />Annual monitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test <br />(M 1) <br />26 <br />HSC 25284.2 <br />Annuals ill containment testing <br />27 <br />CCR 2636 ID14) <br />Annual line tightness test <br />(M1) <br />28 <br />CCR 2661 (f) <br />R22air for tank/ 2i2inhas had tightness test <br />(M2) <br />29 <br />CCR 2643 (e) <br />Biennial tightness test of gravit, , ilpinre-Janna EZ 1, 1984) <br />30 <br />CCR 2643 (d) <br />Triennial line test for conventional suction piping (re -Janus a 1, 1984) <br />(M1) <br />31 <br />HSC 25292.5 <br />Double wall system located within 1000' of 2ublic well-ELD <br />32 <br />CCR 2661 <br />Permit to re air UST system <br />33 <br />HSC 25286 a) <br />Permit to alter monitoring system <br />34 <br />HSC 25298 (b) <br />Permit to tem2orarily close UST system <br />35 <br />HSC 25298 (c) <br />Pen -nit to close UST system <br />36 <br />1 HSC 25299 (a)(9) <br />Disablinleak detection devices <br />37 <br />HSC 25298 1a) <br />Ills al abandonment of UST system <br />38-1 Other: <br />EHD INSPE OR: <br />RECEIVE <br />I <br />PHONE: <br />C'/ <br />TITLE: <br />UIC <br />Sentic system <br />- Serves >:20 people/day <br />- Receives other than sanitary waste <br />Other disposal methods: <br />Dry wells/French Drains <br />EHD 23-02-002 REV 05/07 <br />