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SAN JOA QUIN COUNTY i �V I V/�f I VV' <br /> lJ� _ <br /> `�( :IV <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,California 95202-3029 NOV 6 2008 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.orgjehd <br /> UNDERGROUND STORAGE TANK UST) PROGRAM INSPE&10066W HEALTH <br /> Facil4_ty name: FDesignated Operator: t ; on Date: <br /> "Tq 1/1 �'i ko,'y( <br /> Facilityaddress: <br /> d <br /> UST# <br /> i <br /> Product <br /> Fa'cellty Contact: Title: I Phone: <br /> ,i�i , <br /> r �p <br /> F i <br /> Monitorings Anel• Piping system: OyerFll prevention: <br /> Pressurized El Suction ElGravi Mechanical 11 Audible/visual <br /> Inspection type: j Violations: <br /> Routine 6/Monitoring Certification ❑Installation ❑Other: ©M I-RDetect ❑M2-RPrev ❑M-3 Both <br /> / j VIOLATION(S) HSC=California Health&Safety Code;CCF{=Califomia Code of Regulations V R <br /> ' # Code Section <br /> V=Violation;RV=Re eat Violation V <br /> I HSC 25284 Permit too erate <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 b)& c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form) <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 b Monitoring Program(Monitoring&Response Plan)is current and approved by the local agency. <br /> 6 CCR 2712 i Monitoring plan is onsite. <br /> 7 CCR 2712 b Maintenance&monitorin records M1 w' <br /> 8 1 CCR 2643 d) Daily monitoring of suction Eiping(pre-Januaa, 1, 1984) <br /> 9 HSC 25292.1 UST system iso erated to 2revent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present (Mi) <br /> 11 CCR 2630 d UST system monitoring a ui ment is properly located to detect a leak M1) <br /> 12 HSC 25291 b nitoring a ui ment iso erational (M2) <br /> 13 CCR 2636 1 Continuous monitoring s stem for underground piping&UDC is resent M1 <br /> 14 CCR 2631 a Primary containment is 2roduct tight <br /> 15 HSC 252911, #2Sec4nda ,containment for UST is tight , <br /> 16 CCR?6361c)(1, All r6lemi*iii secondary 2ipingflow to a c611 'orL u e _.._. <br /> 17 H $ 2°§29 �E ' L'melbak"d t to s areinstalled �' -"1 -' (M1) <br /> Ca <br /> 18 CCR`2635(b)(1). S ill container (M2) <br /> 19 C 635 f 2 i t,Oveill re t4bp system04, r.`,a ? -A (M2) <br /> 20 CCR 2636a) `Conventional silctfon piping shall ha t contrruous m nitorin 2°'eontain`ment "' `� <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly7i� �n ® ;" '. �• <br /> 22 CCR 2650 Recording/reporting of unauthorized releases '—- M1 <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner'• (c-e)'Monthly inspection, t)Employee training <br /> 24 CCR 2638 a Annual monitoring certification --- <br /> 25 CCR 2638 a) Annual line leak detector test (M1) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4' Annual line tightness test M1) <br /> 28 CCR 2661 f) Repair for tank/pi2ing has had tightness test (M2) <br /> 29 CCR 2643 a Biennial tightness test of&ravity 12i2in& re-Janus 1, 1984) <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping( re-Janus 1, 1984) (M1) <br /> 31 HSC 25292.5 Double walls stem located within I000'•of ublic wet-ELD <br /> 32 CCR 2661 Permit to repair UST sy <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) Disablin&leak detection devices <br /> 37 HSC 25298 a) Illegal abandonment of UST system <br /> 38 Other: <br /> EHD IIYSPECTORp < PHONE: U!C <br /> q ? <br /> � ,k i i i 4,,� ��_� .t i'f LIA Septic system: <br /> ', t. . rSer�es>_2D people/day <br /> RECEI,V D#, ,J,, e a t� :'�' T1 p ;� ,— i >' `eseivzs other than sanitary waste <br /> e" " � <br /> E fr ,e /�-;'-.�! "� •_ 1 Other disposal methods: <br /> ` !` ! wells/French Drains <br /> �_.._ <br /> `•tee.,°}. ,:" 4 R. 4 <br /> EHD 23-02-002 REV 05/07 <br />