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SAN JOAQUIN COUNTY 0 <br />INVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility name: <br />Designated Operator: <br />Inspection <br />ate: <br />Facility address <br />! <br />UST # <br />�, <br />�' Oroduct <br />/ <br />Facility Contact: <br />71MI, <br />Title: Phone: <br />-66IC2> <br />� <br />/ <br />Mooniittorri g el: <br />CM W—L <br />Piping system: <br />VPressurized ❑ Suction ❑ Gravity <br />Overfill prevention: <br />Mechanical ❑ Audible/visual <br />Inspection type: <br />Routine Monitoring Certification ❑ Installation ❑ Other: <br />Violations: <br />❑ M1-RDetect ❑ M2-RPrev ❑ M-3 Both <br /># <br />Code Section <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=California Code of Regulations V R <br />V=Violation; RV=Re eat Violation V <br />1 <br />HSC 25284 <br />Permit to operate <br />2 <br />CCR 2637 <br />Secondary containment test performed Pc- 6 -a -b. <br />3 <br />CCR 2711 b & c <br />Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br />4 _ <br />HSC 25292.2 <br />Certification of financial responsibility and CFO letter rtrpi.ei� I -6-d11t <br />5 <br />CCR 2632 b <br />Monitoring Program(Monitoring & Response Plan is current and approved by the local a enc .csv- <br />6 <br />CCR 2712 i <br />Monitoring Ian is onsite. <br />7 <br />CCR 2712 b <br />Maintenance & monitoring records M1 <br />8 <br />CCR 2643 d <br />Daily monitoring of suction piping (pre -January, 1, 1984 <br />9 <br />HSC 25292.1 <br />UST system isoperated to prevent unauthorized release <br />10 <br />CCR 2632 (c)(2) <br />UST monitoring system is present M1) <br />11 <br />CCR 2630 d <br />UST system monitoring equipment is properly located to detect a leak M1 <br />12 <br />HSC 25291 b <br />UST s stem monitoring equipment isoperational M1) <br />13 <br />CCR 2636 1 <br />Continuous monitoring system for underground piping & UDC is present M1 <br />14 <br />CCR 2631 a <br />Primary containment is product tight <br />15 <br />HSC 25291 (a)(2) <br />Secondary containment for UST is tight <br />16 <br />CCR 2636 (c)(1) <br />All releases in secondary pipingflow to a collection sum <br />17 <br />HSC 25291 <br />Line leak detectors are installed M1 <br />18 <br />CCR 2635 (b)(1) <br />Spill container (M2) <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system M2 <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 20 containment <br />21 <br />HSC 25291 (e) <br />Water in 20 containment analyzed & properly disposed of <br />22 <br />CCR 2650 <br />Recording/reporting of unauthorized releases M1 <br />23 _ <br />CCR 2715 <br />Designated Operator: a Statement from UST owner; c- Monthly inspection; Employee training <br />24 <br />CCR 2638 a <br />Annual monitoring certification b& jbre, 1-6-0 <br />25 <br />CCR 2638 a <br />Annual line leak detector test [(-('-0,+ M1 <br />26 <br />HSC 25284.2 <br />Annuals ill containment testingu-6-6 <br />27 <br />CCR 2636 4 <br />Annual line tightness test M1 <br />28 <br />CCR 2661 <br />Repair for tank/piping tank/pipinghas had tightness test (M2) <br />29 <br />CCR 2643 a <br />Biennial tightness test of gravity pipingre-Janus 1, 1984 <br />30 <br />CCR 2643 d <br />Triennial line test for conventional suction piping (re -Janus 1, 1984) (M1) <br />31 1 <br />HSC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <br />32 <br />CCR 2661 <br />Permit to repair UST system <br />33 <br />HSC 25286 a <br />Permit to alter monitoring system <br />34 - <br />HSC 25298 b <br />Permit to temporarily close UST system <br />35 <br />HSC 25298 c <br />Permit to close UST system <br />36 <br />HSC 25299 <br />a 9 2 <br />Disabling leak detection devices <br />37 <br />HSC 25298 a <br />Illegal abandonment of UST system <br />38 <br />Other: <br />EHD INSPECTOPHON <br />/'mac r <br />l^� <br />�Q ^ �� <br />666 CJ <br />UIC <br />Seatic system: <br />F1 Septic <br />>_20 people/day <br />❑ Receives other than sanitary waste <br />methods: <br />Other Dry <br />C D wellwells/French Drains <br />RECEIVED BY: <br />TITLE: <br />�n <br />4✓' � <br />EHD 23-02-002 REV 8/08 <br />