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WANIL, SAN JOAQUIN COUNTY <br /> NVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street,Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fav(209)468-3433 Web:www.sjgov.orgje <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: esignated Operator: Inspection Date: <br /> [2 y <br /> Facility address: UST# <br /> Product <br /> Facility Contact: Title: I Phone: <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> _TLS '_;��' I 21pressurized E Suction 0 Gravity Mechanical E Audible/visual <br /> Inspection type: Violations: <br /> "outine "onitoring Certification 11 Installation E Other: 0 MI-RDetect E M2-RPrev 0 M-3 Both <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section V=Violation;RV= eat Violation V <br /> I HSC 25284 Permit too erste <br /> 2_7-CR 2637 Secondaa containment test performed <br /> 3- , R 2711 (b)&(c) Current Unified f <br /> 4 THSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 b Monitorin Pro am(MonitorinE&Response Plan)is current and approved by the local agency. <br /> 6 CCR 2712(i) Monitorin lan is onsite. <br /> 7 CCR 2711_(t) Maintenance&monitoring records Mi) <br /> 8 CCR 2643(d) Daily monitoring of suction pi2ing( re-January, 1, 1984) <br /> _HSC 25-2-9-2.1 UST s stem iso erated to revent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitori (Mi) <br /> _TF_-CCR 2630(d) _LST s stem monitorin a ui ment is roper! located to detect a leak (Mi) <br /> 12 HSC 2529:1 (b) UST s stem monitoring equipment isoperational (M <br /> 13 CCR 2636 -Continuous mo (Mi) <br /> 14 CCR 2631 (a) Prima containment is.roduettight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is ti 7ht <br /> 16 CCR 2636(c)(1) All releases in secunda 2iping flow to a collection sump <br /> 17 HSC 25291 (f) Line leak detector(s)are installed (Mi) <br /> _18_ CCR 2625(b) I) S2ill container (M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system (M2) <br /> 2_0 -CCR 2636(a) Conventional suction i in shall have continuous monitorinE&2'containment <br /> 22 HSC 25291 (e) -Water in 2'containment analyzed&properly disposed of <br /> C <br /> ECCR 2650 RecoLrd�Vr ortin of unauthorized releases (Mi) <br /> D3 -CCR 2715 DesiEnated 22erator:(a)Statement from UST owner; (c-e)Monthly inspection;(f)Em2loyee training <br /> 24 CCR 2638(a) Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (MI) <br /> 26 HSC 25284.2 Annual spill containment testing <br /> 27—7-CR 2636(f)(4) Annual line ti htness test Mi) <br /> 28 1 CCR 2661 (f) R2air for tank/ i�in has�had tightness test (M2) <br /> 29 CCR 2643(e) Biennial ti htness test of avit i in re-Janus 1, 1984) <br /> 30 CCR 2643(d) Triennial line test for conventional suction 12iping(pre-Jams m 1, 1984) (Mi) <br /> 31 HSC 25292.5 Double wal I system located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to aair UST system <br /> 33 HSC 25286(a) Pen-nit to alter monitoring system <br /> 34HSC 25298(b) Permit to temporarily close UST system <br /> 35 HSC 25298 c) Permit to close UST system_ <br /> 361 HSC 25299 1a)(9) Disabling leak detection devices <br /> -3-71 HSC 25298(a) Illegal abandonment of UST system <br /> 38 [Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> Smtic systeriv. <br /> AO N"Orl 7 Serves 210 people/day <br /> RECEIVED19—Y: TITLE: -Receives other than sanitary waste <br /> Other disposal methods: <br /> /711 cl/vx 7 Dry wells/French Drains <br /> EHD 23-02-602 REV 05/07 <br />