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11 I <br />ooQ <br />.y SAN JOA UIN COUNTY <br />a� ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br />oq �� Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />�ikoa� <br />11N"l 12(='RnT1ND cTnRAGF TANK (UST) PROGRAM INSPECTION REPORT <br />Facility name: <br />Designated Operator: Inspection Date: <br />V61�fze/N <br />406CA huglae l07 <br />Facility address: <br />UST # <br />JL�. <br />(,.t� i" ' `'' � ` S � � " " rl/V )'� `� ' <br />"Product <br />� ' <br />�- <br />Facility Contact: <br />Title: Phone: <br />�.�vCt,1%'� �i(Pf� E6211II°►� T N)l}1Nil 24cl Vei <br />l <br />' <br />Monitoring Panel: <br />Piping system: <br />��Ovve�erfill prevention: <br />S0 <br />Pressurized Du` ction ❑ Gravity1KMechanical <br />Audible/visual <br />Inspection type: <br />Violations: <br />&6Routine Ok4onitoring <br />Certification ❑ Installation ❑ Other: <br />❑ M1-RDetect ❑ M2-RPrev ❑ M-3 Both <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=Califomia Code of Regulations V R <br /># <br />Code Section <br />V <br />V=Violation; RV=Re eat Violation <br />I <br />HSC 25284 <br />Permit tooperate <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 responsibility and CFO letter <br />5 <br />CCR 2632 (c)(2)(D) <br />Monitoring & response plan is current and filed with the local agency <br />6 <br />CCR 2712 i <br />& response plan is onsite <br />7 <br />CCR 2712 (b) <br />-Monitoring <br />Maintenance & monitoring records <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 <br />11 <br />CCR 2630 (d) <br />UST system monitoring equipment is properly located to detect a leak <br />12 <br />HSC 25291 <br />UST system monitoring equipment isoperational <br />13 <br />CCR 2636 (f)(1) <br />Continuous monitoring system for underground piping & UDC is present (Mi) <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 (f) <br />Line leak detector(s) are installed (MI) <br />18 <br />CCR 2635 (b)(1) <br />Spill container M2 <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system (MZ) <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 2° containment <br />21 <br />HSC 25291 (e) <br />Water in 2° containment anal zed & properly disposed of <br />22 <br />CCR 2650 <br />Recording/reportingof unauthorized releases Ml <br />23 <br />CCR 2715 <br />Designated Operator: (a) Statement from UST owner; (c -e) Monthlyins ection; (f) Employee training <br />24 <br />CCR 2638 (a <br />Annual monitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test (M1) <br />26 <br />1 HSC 25284.2 <br />Annuals ill containment testing <br />27 <br />CCR 2636 (f)(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 gravity piping(re-Januar 1, 1984 <br />30 <br />CCR 2643 d <br />Triennial line test for conventional suction piping (pre-January1, 1984 Ml <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 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 (a)(9) <br />Disabling leak detection devices <br />37 <br />HSC 25298 (a) <br />Illegal abandonment of UST system <br />38 Other: <br />EHD INSPECTOR: <br />PHONE: <br />UIC <br />,rQ,�^` � �t 3 /I 3 /^ <br />N rll'I,I/ v `f'po `I� �l <br />otic system: <br />❑ Serves >_20people/day <br />❑ Receives other than sanitary waste <br />RECEIVED BY: <br />TITLE: <br />�.t/ACS <br />Other disposal methods: <br />Drains <br />2. <br />w • /v«:" <br />❑ Dry wells/French <br />EHD 23-02 <br />1/3/07 <br />