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SAN JOAQUIN COUNTY <br /> 0NVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3rd Floor, Stockton,CA 95200-0708 <br /> Telephone:(209)468-3420 Foix:(209)468-3433 Web:www.sj og v.org/ehd <br /> UNDERGROUND STORAGE TANK LILST2,PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> � leonr cS00i j # 2-D9119 SILv"} 4120/07 <br /> Facility address: UST# ' 2 <br /> Ci44W f, Product <br /> Facility Contact: Title: Phone: <br /> Nz-rz-_. q1\)uTD6S-5(gv 0�4K q'77- 3 6qq <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> IL& a s7b lvf essurized ❑Suction ❑Gravity &,' echanical ❑Audible/visual <br /> 7ection type: Violations: <br /> outine "onitoring Certification ❑Installation ❑Other: ❑MI-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 too erate <br /> >2 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 responsibility and CFO letter <br /> 5 CCR 2632 c 2 D Monitoring&res onse plan is current and filed with the local a enc <br /> 6 CCR 2712'.i Monitoring'&response plan is onsite'i <br /> 7 CCR 2712 b Maintenance&monitoring records l <br /> 8' CCR 2643 d Daily monitorin of suction piping(pLe-Janun, 1, 1984) <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632 c 2 UST ionitoring system is present Ml <br /> 11 CCR 2630 d UST system monitoring equipment is properly located to detect a leak Ml <br /> 12 HSC 25291 UST system monitoring equipment isoperational M2 <br /> 13 CCR 2636 1 Continuous monitoring system for underground 2i2ing&UDC is present l <br /> 14 CCR 2631 a Prirnary containment is product ti ht-- <br /> 15 HSC 25291 a 2 Secondary containment for UST is ti ht <br /> 16 CCR 2636 c)(1) All releases in secondary pipingflow to a collection sum <br /> 17 HSC 25291 Line leak detectors are installed l <br /> 18 CCR 2635 (1) Spill container Z <br /> 19 CCR 2635(b)(2) Overfill prevention system 2 <br /> 20 CCR 2636,(0) Conventional suction pi in .shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 2 containment analyzed&properly disposed of <br /> 22 CCR 2650' Recordin re rtin&of unauthorized releases` Ml <br /> 23 CCR 2715 Designated O erator:(a)Statement from UST owner; (c-e)Monthly ins ection;(f)Em to ee training <br /> 24 CCR 2638 fP a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test ( l) <br /> 26 HSC 25284.2 Annual s ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test l <br /> 28 1 CCR 2661;(f) Re air for tank/ i ing.has had ti tnss test ( 2 <br /> 29 CCR 2643 e Biennial tightness test of avit i in re-Jana 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suctioni`in a-Janu 1,1984 (Ml <br /> 31 HSC 25292.5 Double wall s stem located within 1000'of 2ublic well-ELD <br /> 32 CCR 2661 Permit to re it UST system <br /> 33 HSC 25286 a Permit to alter monitorin system <br /> 134 1 HSC 25298 Permit to temRorarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299(a)(9) Disabling leak detection devices <br /> 37 HSC 25298 a Ille al abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> /C I 2 ,( ©� Septic system: <br /> ❑Serves>_20 people/day <br /> RECEIVED BY: ITL(E: ❑Receives other than sanitary waste <br /> nOther disposal methods: <br /> ❑Dry wells/French Drains <br /> F,HD 23-02-002 <br />