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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgoy.org/ehd <br /> �1 UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Desied Operator: Inspection Date: <br /> \1 i I Soo W� C�•eVf- J Al;),-il; ��55a�% � <br /> Facility address: UST# , <br /> 143-7 N: Vj 1, Sur') vi , � LIG J - I - , I - . <br /> Product <br /> Facility Contact. Title: Phone: <br /> Z3W . <br /> M jZ7rjn Panel:'} Piping system: Overfill prevention: <br /> ( �3�o Pressurized ❑Suction ❑Gravity ❑Mechanical ❑Audible/visual <br /> lifspection type: Violations: <br /> Routine ❑Monitoring Certification ❑Installation ❑Other: ❑MI-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section <br /> V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 b)& c Current Unified Program Consolidated Forms on the 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 1 CCR 2712 i) Monitoring Ian is onsite. <br /> 7 CCR 2712 b Maintenance&monitoring records M1 <br /> 8 CCR 2643 d) Daily monitoring of suction piping(pre-January, 1, 1984) <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present (M1) <br /> 1 1 CCR 2630 d UST system monitoring equipment is properly located to detect a leak (M 1) <br /> 12 1 HSC 25291 b UST system monitoring equipment isoperational (M2) <br /> 13 CCR 2636(t)(1) Continuous monitoring system for underground piping&UDC is present (M 1) <br /> 14 CCR 2631 a Primary containment is product tight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in secondary piping flow to a collection sum <br /> 17 HSC 25291 t Line leak detector(s)are installed M 1) <br /> 18 CCR 2635(b)(1) Spill container (M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system (M2) <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases xzsM1) <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthl ins ectio tl m to ee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 1 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 (M 1) <br /> 28 CCR 2661 (f) Repair for-tank/piping has had tightness test (M2) <br /> 29 CCR 2643 e Biennial tightness test of gravity piping(pre-January I, 1984) <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping(pre-January I, 1984) (M1) <br /> 31 1 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 /> 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) Disabling leak detection devices yu '1 <br /> 37 1 HSC 25298 a) 4141 Illegal abandonment of UST system +� <br /> 38 1 Othet-CC 2(p V41194 h SW&j,,%j1n' a/ Q/ `J tVZOVA Tog T MwIft DNA <br /> EH INSPECTOR: PHONE: UIC <br /> (Oct-, 2 (/� cf� 11Septic syster . <br /> RECE ED Y [ O <br /> -S er es>_20 ple/day <br /> TITLE: —Receives other sanitary waste <br /> Other disposal methods: <br /> Dry wells/French Drains <br /> PY �� <br /> EHD 23-02-002 REV 05/07 <br />