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SAN JOAQUIN COUNTYAOL <br />DATE I 'Z <br />PR# 1D• <br />4NVIRONMENTAL HEALTH DEPARIONT PAGE o ° <br />304 E. Weber Ave., Third Floor, Stockton, CA 95202 <br />(209) 468-3420 <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility Name 75 �acility Address 2 -7D5 �Oua4r� 1 <br />Facilty Contact P&SA24 I'DM&&MUe A qn,4%?42 Phone # L/1055 C( 7 <br />UST# Product UST# Product ��UST#_Product blzUST# Product <br />Overfill Prevention: ❑ AudibleNisual Mechanical Monitoring Panel: <br />Piping System: ❑ Gravity (Pressure ❑ Suction Violations: KMinor ❑ Major <br />Automatic Pump Shut Down Satisfies CCR 2636 (g): ❑ Yes No Dispenser Pan: [des []No NPia v® /'a, <br />INSPECTION TYPE: Toutine�Vonitoring Certification ❑Complaint ❑install ❑Removal ❑Repair/Upgrade <br />COMPANY NAME: tJV- 4V, TECHNICIAN NAME: '70f l Rev' S PHONE: (774,7) ycLe,, Co <br />The above facility is not in compliance with the following section(s) of Health & Safety Code (HSC) and/or <br />California Code of Regulations (CCR): <br />1 HSC 25284 Permit to operate I 20 CCR 2712 (b) Maintenance & monitoring <br />2 CCR 2637 <br />3Is/ CCR 2711(b) & (c) <br />4 HSC 25292.2 <br />5CCR <br />2630 (d) <br />6 <br />CCR 2636 (c)(1) <br />7 <br />HSC 25291 (e) <br />8 <br />HSC 25291 (f) <br />9 <br />CCR 2636 (f)(1) <br />10 <br />CCR 2632 (c)(2) <br />11 <br />HSC 25291(a)(2) <br />17 CCR 2650 <br />18 CCR 2632 (d) <br />19 CCR 2712 (i) <br />Secondary cont testing (6 <br />month/36 month) <br />Current State Forms A & B <br />Certification of financial <br />responsibility and letter from <br />chief financial officer <br />Continuous monitoring system <br />for UST system <br />All releases in secondary piping <br />flow to a collection sump <br />Water in secondary (20) cont <br />Automatic line leak detector(s) <br />Continuous monitoring system <br />for underground piping <br />Continuous monitoring system <br />for UST <br />Secondary containment for <br />UST is tight <br />Continuous monitoring system <br />for dispenser system <br />Spill container <br />Overfill prevention system <br />Primary containment is product - <br />tight <br />UST system is operated to <br />prevent unauthorized release <br />Recording/reporting <br />unauthorized release <br />Monitoring & response plan <br />Monitoring & response plan is <br />on site <br />records <br />21 CCR 2636 (f)(4) Annual line tightness test <br />22 <br />VCCR <br />12 <br />2636 (f)(1) <br />13 <br />CCR 2635 (b)(1) <br />14 <br />CCR 2635 (b)(2) <br />15 <br />CCR 2631 (a) <br />16 <br />HSC 25292.1 <br />17 CCR 2650 <br />18 CCR 2632 (d) <br />19 CCR 2712 (i) <br />Secondary cont testing (6 <br />month/36 month) <br />Current State Forms A & B <br />Certification of financial <br />responsibility and letter from <br />chief financial officer <br />Continuous monitoring system <br />for UST system <br />All releases in secondary piping <br />flow to a collection sump <br />Water in secondary (20) cont <br />Automatic line leak detector(s) <br />Continuous monitoring system <br />for underground piping <br />Continuous monitoring system <br />for UST <br />Secondary containment for <br />UST is tight <br />Continuous monitoring system <br />for dispenser system <br />Spill container <br />Overfill prevention system <br />Primary containment is product - <br />tight <br />UST system is operated to <br />prevent unauthorized release <br />Recording/reporting <br />unauthorized release <br />Monitoring & response plan <br />Monitoring & response plan is <br />on site <br />records <br />21 CCR 2636 (f)(4) Annual line tightness test <br />22 <br />CCR 2630 (d) <br />Annual line leak detector test <br />23 <br />CCR 2630 (d) <br />Annual monitoring certification <br />24 <br />CCR 2643 (d) <br />Daily monitoring of suction <br />piping that is not continuously <br />monitored <br />25 <br />CCR 2643 (d) <br />Triennial tightness test of <br />suction piping that is not <br />continuously monitored <br />26 <br />CCR 2643 (e) <br />Biennial tightness test of gravity <br />piping that is not continuously <br />monitored <br />27 <br />CCR 2662 <br />Upgrade requirements for UST <br />system <br />28 <br />CCR 2661 <br />Permit to repair UST system <br />29 <br />HSC 25286 (a) <br />Permit to alter monitoring <br />system <br />30 <br />HSC 25298 (a) <br />Illegal abandonment of UST <br />system <br />31 <br />HSC 25298 (b) <br />Permit to temporarily close UST <br />system <br />32 <br />HSC 25298 (c) <br />Permit to close UST system <br />33 <br />HSC 25291 (e) <br />Water in 20 cont analyzed and <br />properly disposed of <br />34 <br />CCR 2640 (e) <br />Single wall component within <br />1000' of Public Well, no ELD <br />35 <br />CCR 2635(a)(2)(A) Cathodic protection testing <br />36 <br />H&SC 25299(a)(9)Disabling leak detect. devices <br />37 <br />Violation(s) not listed above <br />EHD INSPECTOR: <br />PHONE: <br />LIP " q 4 <br />RECEIVED BY: <br />TITLE: MtiNA�- e 2 <br />,-PHONE: <br />UNITIIUUSPINSP (rev W5102) <br />