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0 SAN JOAQUIN COUNTY <br />IRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.siqov.org/ehd <br />UNDERGROUND STORAGE TANK (USTI PROGRAM INSPECTION REPORT ---- --- <br />Facility name: Designated Operator: Inspection <br />&A Date: <br />Vy\ JMA A t C) <br />Facility address: UST <br />.4 W COWTVIL product <br />Facility Contact: Title: Phone: <br />-7-ArrAt PIC-NeAOL,0 Gr4VC900ffWK"L &MK4AWC,= <br />Monitoring Panel: TZ-54 <br />y*_V-j>u-9- RzoT 7 <br />,,6b <br />Piping system: <br />[I Pressurized Y'Suction 0 Gravity <br />Overfill prevention: <br />1 0 Mechanical 0 Audible/visual <br />Inspection type:Violations: <br />--NrRoutine N/Monitorin Certification 0 Installation 0 Other: 0 M1-RDetect 0 M2-RPrev 11 M-3 Both <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=California Code of Regulations V R <br /># Code Section V=Violation; RV=Repeat Violation V <br />1 <br />HSC 25284 <br />Permittooperate <br />2 <br />CCR 2637 <br />Secondary containment test performed <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 responsibili!y and CFO letter <br />5 <br />CCR 2632 (b) <br />Monitorin Program (Monitoring & Response Plan) is current and approved by the local ageng. <br />6 <br />CCR 2712 (i) <br />Monitorin Ian is onsite. <br />7 <br />CCR 2712 (b) <br />Maintenance & monitorin2 records (MI) <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 />LIST monitoring system is present (Mi) <br />11 <br />CCR 2630 d <br />UST system monitoring equipment is properly located to detect a leak (MI) <br />12 <br />HSC 25291 (b) � <br />UST system monitoring equipment isoperational (MI) <br />13 <br />CCR 2636 (f)(1) <br />Continuous monitoring system for under round piping & UDC is present (MI) <br />14 <br />CCR 2631_(a) <br />Primary containment is product tight <br />15 <br />_ <br />HSC 25291 MR)_ <br />Secondary containment for LIST is tight <br />16 <br />CCR 2636 (c)(1) <br />All releases in seconds !y iping flow to a collection sum <br />17 <br />HSC 25291 <br />Line leak detector(s) are installed (MI) <br />18 <br />1 CCR 2635 (b)(1) <br />Spill container (M2) <br />19 <br />1 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 />/reporting of unauthorized releases (MI) <br />23 <br />CCR 2715 <br />_B222rdin <br />Designated Operator: (a) Statement from LIST owner; (c-e) Monthly inspection; Ern loyee training <br />24 <br />CCR 2638 (a) <br />Annual monitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test (MI) <br />26 <br />HSC 25284.2 <br />Annuals ill containment testin2j_ <br />27 <br />CCR 2626 4 <br />Annual line tightness test (MI) <br />28 <br />CCR 2661 <br />Repair for tank/piping has had tightness test (M2) <br />29 <br />CCR 2643 (e) <br />Biennial tightness test of qravity piping (pre-January 1, 1984) - <br />30 <br />CCR 2643 (d) <br />Triennial line test for conventional suction 2iping (pre-Janus !Y 1, 1984) <br />31 <br />HSC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <br />32 <br />CCR 2661 <br />Permit to repair LIST system <br />33 <br />1 HSC 25286 (a) <br />Permit to alter monitorinq system <br />34 <br />25�� <br />Permit to temporarily close LIST system <br />�35 <br />HSC 25298 (c) <br />Permit to close LIST system <br />36 <br />' LHSC <br />HSC 25299 <br />(al(g)(f)(2) <br />Disabling leak detection devices <br />�37 <br />HSC 25298 (a) <br />Illegal abandonment of UST system <br />38 <br />Other: <br />'EHIDINSPECTOR: <br />A4 <br />D <br />EHD 23-02-002 REV 8/08 <br />PHONE: UIC <br />Septic system: <br />[I Serves >_20 people/day <br />TITLE:. El Receives other than sanitary waste <br />Other disposal methods: <br />0 Dry wells/French Drains <br />