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SAN JOAQUIN COUNTY <br />ONVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sj ov.or /g ehd <br />UIN1)hKUKUUINU SIUKA(ih1'ANK (US•1') PKU(TKAM 1NSYEC'1'101N REPORT <br />Facility name: <br />37 HSC 25298 (a) Illegal abandonment of UST system <br />Designated Operator: <br />Inspection Date: <br />PHONE: <br />5i OQ <br />13 `� <br />° ��►�tL� oni k N&v <br />3 <br />Facility address: <br />TITLE: <br />UST # <br />L� "� �^`' <br />disvosal methods: <br />UIN1)hKUKUUINU SIUKA(ih1'ANK (US•1') PKU(TKAM 1NSYEC'1'101N REPORT <br />Facility name: <br />37 HSC 25298 (a) Illegal abandonment of UST system <br />Designated Operator: <br />Inspection Date: <br />PHONE: <br />5i OQ <br />13 `� <br />° ��►�tL� oni k N&v <br />Septicsystem: <br />0 Serves >_20 people/day <br />0 Receives other than sanitary waste <br />Facility address: <br />TITLE: <br />UST # <br />L� "� �^`' <br />disvosal methods: <br />k` G 3 U tJ ( 0 <br />L.14 P Lv fl <br />1 <br />Product <br />Facility Contact: <br />Title: Phone: <br />[Monitoring <br />Panel: <br />Piping system: <br />Overfill prevention: <br />6i%-6P'fL(.sa <br />Pressurized ❑ Suction ❑ Gravity <br />❑ Mechanical ❑ Audible/visual <br />Inspection type: <br />Violations: <br />Routine Monitoring Certification ❑ Installation ❑ Other: <br />❑ M1-RDetect ❑ M2-RPrev <br />❑ M-3 Both <br />VIOLATIONS) HSC=California Health & Safety Code; CCR=California Code of Regulations <br />V R <br /># <br />Code Section <br />`, <br />V=Violation; RV=Re eat Violation <br />I <br />HSC 25284 <br />Permit to operate <br />2CC'R <br />2637:cantaittent <br />test: rm <br />3 <br />CCR 2711 & c <br />Current Unified Pro am Consolidated Forms on file with EHD (Facility and tank form) <br />4j <br />HSC 25292.2ertifictltiin <br />of ftiiancia] re bili and CFO letter <br />5 <br />CCR 2632 c 2 (D) <br />Monitoring & response plan is current and filed with the local agency <br />712 i <br />Wnitorinj &res onse planis.onsite <br />7 <br />CCR 2712 <br />Maintenance & monitoring records <br />(Mi) <br />:8 <br />C°CR 2143',: <br />mtt60l of suction i ` `n (pre -January, 1, 1984) <br />9 <br />HSC 25292.1 <br />UST s tem isoperated to prevent unauthorized release <br />10 <br />CCR 2632; <br />' f s stem is reserrt <br />Ml <br />11 <br />CCR 2630 d <br />UST system monitorinui ment is 2Merly located to detect a leak <br />Ml <br />ILL <br />HSC 25291 3 <br />ilii' , tt itarittipment,is operational <br />IMP <br />13 <br />CCR 2636 1 <br />Continuous monitoringsystem for underground piping & UDC is resent <br />Ml <br />1 <br />3b31 <br />tis product tight <br />15 <br />HSC 25291 (a)(2) <br />Secon containment for UST is tight <br />1 <br />GCS 2636=1; <br />:.: eond ary-1 . it1 ;flaw to a coitectionsump <br />17 <br />HSC 25291'(f) <br />Line leak detector(s) are installed <br />Ml <br />. :. ,2i€ <br />19 <br />CCR 2635 2 <br />Overfill Mevention system <br />M2 <br />CMU X(w)V <br />C atw tiriit al suction pi in &shalllFlaYe Gontitltlolis monitoring & 2°Containment <br />21 <br />HSC 25291 (e) <br />Xe IX disposed of <br />Water in 2° containment analyzed & ffo <br />RMit lease's' <br />1 <br />23 <br />CCR 2715 <br />Designated O erator: a Statement from UST owner; (c -e) Monthly inspection; Employee trainin <br />a <br />25 <br />CCR 2638 a <br />Annual line leak detector test <br />(Mi) <br />26 <br />1252&4.2 . .AWOOffi <br />27 <br />CCR 2636 4 <br />Annual line ti htness test <br />Ml <br />C)1'.. <br />lead ti Hess test <br />M2 <br />29 <br />CCR 2643 a <br />Biennial tightness test of avi i in re-Jan1 1984 <br />1 ;264 d <br />i l test for cotivetidofj*o on " ` e-Jenoary1 y 19$4 <br />Ml <br />31 <br />HSC 25292.5 <br />Double wall Mtem located within 1000' of public well-ELD <br />32 <br />CLQ X6611: <br />UST s stem <br />33 <br />HSC 25286 a <br />Permit to alter monitoring system <br />'34 <br />HSC 2529$ <br />sE. ''. 1 Blow UST . teem , <br />35 <br />HSC 25298 c <br />Permit to close UST s stem <br />36 HSC 25294,'( 9) bi bl ete4 Jovices . <br />37 HSC 25298 (a) Illegal abandonment of UST system <br />38 Other: <br />EHD INSPECTOR: <br />PHONE: <br />UIC <br />I L LJ N G <br /><'Z i"1 5 ' <br />Septicsystem: <br />0 Serves >_20 people/day <br />0 Receives other than sanitary waste <br />RECEIVED BY: <br />TITLE: <br />P4-1�Other <br />L� "� �^`' <br />disvosal methods: <br />0 Dry wells/French Drains <br />EHD 23-02-002 <br />