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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3`d Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sj og v.or /�ehd <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility name: <br />Designated Operator: <br />Inspection Date: <br />✓ QJ <br />pd;®I <br />o <br />Facility address: <br />UST # <br />I <br />Secondary containment test performed <br />3 <br />ills n` <br />Product <br />1�1� <br />HSC 25292.2 <br />Certification of financial res2onsibility and CFO letter <br />Facilit Cont ct: Title: Phone: <br />CCR 2632 c 2)(D) <br />Monitoring & response plan is current and filed with the local agency <br />6 <br />CCR 2712 i <br />1 <br />7 <br />CCR 2712 <br />Maintenance & monitorin records <br />Ml <br />nel: <br />Piping syst : <br />Overfill prevention: <br />`itorin <br />i1/S AAQ ` <br />❑ Pressurized Suction ❑ Gravity <br />Mechanical ❑ Audible/visual <br />I <br />Inspection type: <br />Violations: <br />UST monitorin s stem is present <br />Routine Monitoring Certification ❑ Installation ❑ Other: <br />❑ MI-RDetect ❑ M2-RPrev <br />❑ M-3 Both <br /># <br />Code Section <br />VIOLATION(S) e oegu <br />S) HSC=California Health & Safety Code; CCR=California Code Regulations V R V=Violation; RV=Re eat Violation v <br />1 <br />HSC 25284 <br />Permit tooperate <br />2 <br />CCR 2637 <br />Secondary containment test performed <br />3 <br />CCR 2711 b & c <br />Current Unified Pro am Consolidated Forms on file with EHD(Facility and tank form <br />4 <br />HSC 25292.2 <br />Certification of financial res2onsibility and CFO letter <br />5 <br />CCR 2632 c 2)(D) <br />Monitoring & response plan is current and filed with the local agency <br />6 <br />CCR 2712 i <br />Monitoring & response planis onsite <br />7 <br />CCR 2712 <br />Maintenance & monitorin records <br />Ml <br />8 <br />CCR 2643 (d) <br />Daily monitoringof suction piping (re -January, 1, 1984) <br />9 <br />HSC 25292.1 <br />UST system isoperated to prevent unauthorized release <br />10 <br />CCR 2632 (c)(2) <br />UST monitorin s stem is present <br />(Mi) <br />11 <br />CCR 2630 d <br />UST system monitoring equipment is properly located to detect a leak <br />MI <br />12 <br />HSC 25291 <br />UST system monitoring equipment isoperational <br />2 <br />13 <br />CCR 2636 1 <br />Continuous monitoring system for under ound piping & UDC is present <br />l <br />14 <br />CCR 2631 a <br />PriEM containment is 2roduct tight <br />15 <br />HSC 25291 (a)(2) <br />Secondary containment for UST is tight <br />16 <br />CCR 2636 (c)(1) <br />All releases in secondary pipingflow to a collection sum <br />17 <br />HSC 25291 <br />Line leak detectors are installed <br />Ml <br />18 <br />CCR 2635 (b)(1) <br />"S ill container <br />M2 <br />'19 <br />CCR 2635 (b)(2) <br />Overfill prevention system <br />M2 <br />20 <br />CCR 2636 (a) <br />Conventional suction jiping shall have continuous monitoring & 2° containment <br />21 <br />`HSC 25291 (e) <br />Water in 2° containment analyzed & properly disposed of <br />22 <br />CCR 2650 <br />Recording/reporting of unauthorized releases <br />Mi <br />23 <br />'CCR 2715 <br />Desig2ated erator: a) Statement from UST owner; (c -e) Monthly ins ection; ( <br />Em to ee training <br />24 <br />'CCR 263$ 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 />Annual ..s ill containment testing <br />27 <br />CCR 2636 4 <br />Annual line ti htness test <br />Ml <br />28 <br />CCR 2661 (D <br />Repair for tank/piping has had ti tness test <br />(2 <br />29 <br />CCR 2643 e <br />Biennial tightness test of gravity pipingre-Janus 1, 1984 <br />30 <br />CCR 2643 (d) <br />Triennial line test for conventional suction pi2ing (pre -January 1, 1984) <br />(i <br />31 <br />HSC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <br />32 <br />CCR 2661 <br />Permit to repair UST system <br />33 <br />HSC 25286 a <br />Permit to alter monitoring system <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 />38 <br />Other: <br />EU6 INSP CTOR:PHONE: <br />RigServes <br />RIECEI*B1 <br />s <br />TITLE: <br />-® <br />UIC <br />Se tp is system: <br />>_20 people/day <br />7 Receives other than sanitary waste <br />Other disposal methods: <br />-Dry wells/French Drains <br />EHD 23-02-002 <br />