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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:%vww.sjgov.org/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspe tion Date: <br /> Cffi) zm 'y <br /> Facility address: UST# , <br /> Product <br /> F 'fi Conti Pone: <br /> TMZ� <br /> EM I-RDetect El M2-RPrev El M-3 Both <br /> toring Pane- Piping system: Overfill prevention: <br /> Pressurized [I Suction El Gravi!y Mechanical U Audible/visual <br /> Violations:Inspection type: Violations: <br /> Vou60tine El Monitoring Certification D Installation 11 Other: <br /> I # Code Section VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations _R <br /> V=Violation;RV=Repeat Violation V <br /> I HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 b)&(c) Current Unified Pro am 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) MonitorinE Proam(MonitorinE&Response Plan)is current <br /> 6 CCR 2712(i) Monitorinlan is onsite. <br /> 7 CCR 2712(b) Maintenance&monitoring records (MI) <br /> 8 CCR 2643(d), Daily monitoring of suction pil)ing(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 (M 1) <br /> I I CCR 2630(d) UST system momtormE equipment is 2ro2erly located to detect a leak (M 1) <br /> 12 HSC 25291 (b) UST system monitoring equipment isoperational (M2) <br /> 13 CCR 2636(f)(1) Continuous monitoring system for under round <br /> 14 CCR 2631 (a) Prima containment is product tight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 2636 c All releases in secondaa pi2inE flow to a collection sum <br /> 17 HSC 25291 (t) Line leak detector(s)are installed (M1 <br /> 18 CCR 2635(b)(1) _Sill container (V[2) <br /> 19 CCR 2635(b)(2Overfill prevention system (M2) <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2'containment <br /> 21 HSC 25291 (c) Water in 2'containment analyzed&properly disposed of <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;(f) Em loyee trainin� <br /> 24 CCR 2638(a) Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (M 1) <br /> 26 HSC 25284.2 Annual spill containment testing <br /> 27 1 CCR 2636 D 4) Annual line tightness test (M1) <br /> 28 CCR 2661 (f) Repair for tank/v, in has had tiEhtness test (V12) <br /> 29 CCR 2643(e) Biennial tightness test of Eravity piping(pre-Janua!X 1, 1984) <br /> 30 CCR 2643(d) Triennial line test for conventional (M 1) <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD V7 <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 J <br /> 37 HSC 25298 a) Illegal abandonment of UST system <br /> 38 Other: <br /> EHTT I CIO OR: Sept s steni Ulf <br /> Serves>_20 peopleiday <br /> IXy <br /> RE EIVEDI:, TIT Receives other than sanitary waste <br /> Other disnosal methods: <br /> iu Dry wells/French Drains <br /> EHD 23-02-002 REV 05/07 <br />