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DATE <br />SAN JOAQUIN COUNTY PR# 0L3((q& <br />ENVIRONMENTAL HEALTH DEPA*ENT PAGE / <br />304 E. Weber Ave., Third Floor, Stockton, 95202 <br />(209) 468-3420 <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility Name <br />Facility Address <br />Maintenance & monitoring <br />month/36 month) <br />Facilty Contact lam -A -Title <br />HSC 25292.2 <br />� Phone # <br />_1b1 <br />UST# k Product_ <br />UST# 2 Products <br />ST#,Product `� UST# <br />Product <br />Overfill Prevention: ❑ AudibleNisual 216echanical <br />Monitoring Panel: <br />Violations: <br />TL 5 <br />3S—C) <br />Daily monitoring of suction <br />flow to a collection sump <br />Piping System: ❑ Gravityressure <br />❑ Suction <br />HSC 25291 (f) <br />44inor <br />❑ Major <br />Automatic Pump Shut Down Satisfies CCR 2636 (g): ¢fifes <br />❑ No Dispenser Pan: <br />9,1(es <br />❑ No <br />1 <br />2- <br />3_ <br />.4 <br />5- <br />6_ <br />7_ <br />8 <br />9- <br />10 <br />INSPECTION TYPE: PRoutine ❑Monitoring Certification ❑Complaint ❑Install ❑Removal ❑Repair/Upgrade <br />COMPANY NAME: <br />TECHNICIAN NAME: <br />VIOLATION(S) <br />PHONE: <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 />HSC 25284 Permit to operate <br />CCR 2637 <br />Secondary cont testing (6 <br />Maintenance & monitoring <br />month/36 month) <br />CCR 2711(b) & (c) Current State Forms A & B <br />HSC 25292.2 <br />Certification of financial <br />2636 (f)(4) <br />responsibility and letter from <br />22 <br />chief financial officer <br />CCR 2630 (d) <br />Continuous monitoring system <br />CCR 2630 (d) <br />for UST system <br />CCR 2636 (c)(1) <br />All releases in secondary piping <br />Daily monitoring of suction <br />flow to a collection sump <br />HSC 25291 (e) <br />Water in secondary (21) cont <br />HSC 25291 (f) <br />Automatic line leak detector(s) <br />.CCR 2636 (f)(1) <br />Continuous monitoring system <br />CCR 2636 (a) <br />for underground piping <br />CCR 2632 (c)(2) <br />Continuous monitoring system <br />shall have continuous <br />for UST <br />11 HSC 25291(a)(2) Secondary containment for <br />UST is tight <br />12 CCR 2636 (f)(1) Continuous monitoring system <br />for dispenser system <br />13 CCR 2635 (b)(1) Spill container <br />14 CCR 2635 (b)(2) Overfill prevention system <br />15 CCR 2631 (a) Primary containment is product - <br />tight <br />16 HSC 25292.1 UST system is operated to <br />prevent unauthorized release <br />17 CCR 2650 Recording/reporting <br />unauthorized release <br />18 CCR 2632 (d) Monitoring & response plan <br />19 CCR 2712 (i) Monitoring & response plan is <br />on site <br />EHD INSPECTOR: <br />RECEIVED BY: <br />UNM(VUS7/INSP (rev 724/02) <br />20 <br />CCR 2712 (b) <br />Maintenance & monitoring <br />records <br />21 <br />2636 (f)(4) <br />Annual line tightness test <br />22 <br />IZCCR <br />CR 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 2636 (a) <br />Conventional suction piping <br />shall have continuous <br />monitoring & 20 containment <br />26 <br />CCR 2643 (e) <br />Biennial tightness test of gravit} <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 US�,. <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 />PHONE: W <br />'TITLE: <br />