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0 SAN JOAQUIN COUNTY <br />hNVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sslgov.org/ehd <br />rnvn1FRC-Rn1tivn STORAGR TANK (ITST) PROGRAM INSPECTION REPORT <br />Facility name: Designated Operator: <br />CA*v0-0 2oi �$3 c,,,���tiv►J S>.t_JA <br />Inspection Date: <br />Facility address: C UST # <br />" [6 W • �►.�1F 7T. Product <br />Q <br />Z <br />Facility Contact: Title: Phone: <br />CA�- -1 1�Abk(z— q3e <br />- <br />MItoring <br />Panel- <br />'(LS <br />Pi ing system: Overfill prevention: <br />pressurized ❑ Suction ❑ Gravity Mechanical ❑ Audible/visual <br />Inspection type: <br />Routine ❑ Monitoring <br />Violations: <br />Certification ❑ Installation ❑ Other: ❑ M1-RDetect ❑ M2-RPrev ❑ M-3 Both <br /># <br />Code Section <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=California Code of Regulations V R <br />V <br />V=Violation; RV=Re eat Violation <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 Program Consolidated Forms on file with EHD(Facility and tank form) <br />4 <br />HSC 25292.2 <br />Certification of financial responsibility and CFO letter <br />5 <br />CCR 2632 b <br />Monitoring Program(Monitoring & Response Planis current and approved by the local agency. <br />6 <br />CCR 2712 i) <br />Monitoring plan is onsite. <br />7 <br />CCR 2712 b <br />Maintenance & monitoring records Ml <br />8 <br />CCR 2643 d) <br />Daily monitoring of suction piping (pre -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 monitoring system is present (MI) <br />11 <br />CCR 2630 d) <br />UST system monitoring equipment is properly located to detect a leak (MI) <br />12 <br />HSC 25291 b) <br />UST system monitoring equipment isoperational (M2) <br />13 <br />CCR 2636 1 <br />Continuous monitoring system for underground piping & UDC is present (Ml) <br />14 <br />CCR 2631 a) <br />Primary containment is product 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 piping flow to a collection sum <br />17 <br />HSC 25291 <br />Line leak detector(s) are installed (Ml) <br />18 <br />CCR 2635 (b)(1) <br />Spill container (M2) <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system M2) <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 20 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 Ml <br />23 <br />CCR 2715 <br />DesignatedOperator: (a) Statement from UST owner; (c -e) Monthly inspection; (f) Employee training <br />24 <br />CCR 2638 a <br />Annual monitoring certification <br />25 <br />CCR 2638 a) <br />Annual line leak detector test (M1) <br />26 <br />HSC 25284.2 <br />Annuals ill containment testing <br />27 <br />CCR 2636 4) <br />Annual line tightness test Ml <br />28 <br />1 CCR 2661 (f) <br />Repair for tank/piping has had tightness test (M2) <br />29 <br />1 CCR 2643 e <br />Biennial tightness test of gravity piping(pre-January 1, 1984 <br />30 <br />CCR 2643 d) <br />Triennial line test for conventional suction piping (pre-January1, 1984) (Ml) <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 HSC 25298 (b) <br />Permit to temporarily close UST system <br />35 <br />HSC 25298 c) <br />Permit to close UST system <br />36 HSC 25299 a)(9) <br />Disabling leak detection devices <br />37 HSC 25298 a <br />Illegal abandonment of UST system <br />38 Other: <br />EHD INSPECTOR: <br />wwo-1 I^ <br />PHONE: <br />46%-3'�`�� <br />UIC <br />Septic system: <br />❑ Serves >_20 people/day <br />❑ Receives other than sanitary waste <br />Other disposal methods: <br />=i Dry wells/French Drains <br />RECEIV <br />ILZ� <br />TITLE: <br />LTJ <br />EHD 23-02-002 REV 05/07 <br />