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P' <br /> SAN JOAQUIN COUNTY <br /> VIRONMENTAL HEALTH DEPARTMENT <br /> +` 304 East Weber Avenue,3`d Floor, Stockton,CA 9520 -v 108 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.orgLehd <br /> UNDERGROUND STORAGE TANK UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Insection Date: <br /> I k I ell till(, <br /> Facility address: UST# <br /> S G Product <br /> Facility Contac : Ti le: Phone: <br /> Gm cY <br /> o 'tori g anel: Piping system: Overfill prevention: <br /> ' o 1 Pressurized ❑Ictlion ❑ ravity Mechanical ❑Audible/visual <br /> In pection type: Violations: <br /> ❑Routine Monitoring Certification ❑Installation ❑Other: M I-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATIONS) HSC=California Health&Safety Code;CCR=California Code of Regulations V R V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit tooperate <br /> 2'i CCR 2637-- Secondary containment test performed <br /> 3 CCR 2711 & c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br /> 4' HSC 25292.2 Certification of financial i7es2onsibility and CPO letter <br /> 5 CCR 2632 c 2 D Monitoring&res onse 21an is current and filed with the local agency <br /> 6`` CCR 2"712'i Monitoring'&res onse plan is onsite' <br /> 7 CCR 2712 b Maintenance&monitoring records l <br /> 8 CCR 2643 d Daily monitorinE of suction piping(pre-Janun, 1, 1984) <br /> 9 HSC 25292.1 UST system isoperated to 2revent unauthorized release <br /> 14 CCR 2632(c)(2) UST monitorin system is present Mi <br /> 11 I CCR 2630 d UST system monitoring equipment is pEMerly located to detect a leak l <br /> 12 HSC 25291 L UST systeni monitoring Mipment is operational M2 <br /> 13 CCR 2636 1 Continuous monitoring system for underground 2iping&UDC is present Ml <br /> 14 CCR 2631 a 'primanLcLontainment is p12duci tight <br /> 15 SC 25291 (a)(2) Seconds containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in secondary pipingflow to a collection sum Vol <br /> 17 1 HSC 25291 Line leak detectors are installed l <br /> 18 CCR 2635(b)(1) Spill container 2 <br /> 19 CCR 2635(b)(2) Overfill prevention system 2 <br /> 2U CCR 2636',(a) Conventional suction i "ng shall have continuous monitorin &2'containment <br /> 21 HSC 25291 (e) Water in 2 containment analyzed&pro2erly disposed of <br /> b22 CCR 2650Recor ling/reporting of unauthorized releases Mi <br /> 23 CCR 2715 Desi ated erator:(a)Statement from UST owner; (c-e)Monthly ins ection; f)Employee trainin <br /> ,24 1 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test l <br /> ,26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test i <br /> 28 CCR 2661 Repair` for tank/ i in has had tightness test (M2 <br /> 29 CCR 2643 a Biennial tightness test of gavity pipingre-Jana 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction i in re-Jana 1,1984:.. Mi <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 3 HSC 25298 Permit to tompclrarily close UST s qem <br /> 35 1 HSC 25298 c Permit to close UST system <br /> 1-36 HSC 25293(a)(9) Disabling leak detection devices <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other: <br /> EHr INS CTOR: PHONE: UIC <br /> El S" Septic system: <br /> Serves>_20 people/day <br /> RECEIVEDBA TITLE. ❑Receives other than sanitary waste <br /> Other disposal methods: <br /> wells/French Drains <br /> FHD 23-02-002 <br />