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® SAN JOAQUIN COUNTY <br /> NVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3`d Floor,Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Fox:(209)468-3433 Web:www.sj og v.org/ehd <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> STl7P I Zl ^/ G1N /Nf, / / 106 <br /> Facility address: UST# 57 <br /> h , <br /> / Product ' 7 <br /> Facility Contact: Title: Phone: <br /> Su?- MOttC006-F- kA-(42 OWNE-9- QWq) ZY1-2RS-f <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> O/ TLS ,3 LKYressurized ❑Suction ❑Gravity Cfechanical ❑Audible/visual <br /> RIns ection type: �/ Violations: <br /> outine /Monitoring Certification ❑Installation 0 Other: ❑M1-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATIONS) HSC=California Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section V <br /> V=Violation;RV=Re eat Violation <br /> 1 HSC 25284 Permit tooperate <br /> 2CCR 2637 Second2a containment test perfonned <br /> 3 CCR 2711 b & c Current Unified Program Consolidated Forms on file with EHD Facili and tank form <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 c 2 D Monitorin &response plan is current and filed with the local a enc <br /> 6' CCR 2712'i Monitoring&res onse plan is onsite <br /> 7 CCR 2712 b Maintenance&monitorin records l <br /> 8' CCR 2643 d Daily monitoring of suction piping re-Janu; , 1, 1984 <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 14 CCR 2632(c)Q) UST monitoring system is present Ml <br /> 11 CCR 2630 d UST s stem monitoring equipment is pr2perly located to detect a leak ( l <br /> 12 HSC 25291 UST system monitoring equigment is v erational M2 <br /> 13 CCR 2636 1 Continuous monitoring system for under ound piping&UDC is present Ml <br /> 14 CCR 2631 a Prunary containment is Rroduct ti ht' <br /> 15 1 HSC 25291 (a)(21 Secondary containment for UST is ti ht <br /> 16 CCR 2636 c)(1)) All releases in second2g 2jpingflow to a collection sum <br /> 17 HSC 25291 ( Line leak detectors are installed l <br /> 18 CCR 2635',(b)(1) Spill container M2 <br /> 19 CCR 2635 2 Overfill prevention system 2 <br /> 20 CCR 2636',(a) Conventional suction piping shall have continuous monitorin &2°containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&2ro2erly disposed of <br /> -22 CCR 2650 Recording/reporting of unauthorized releases' Ml <br /> 23 CCR 2715 Desi ated O erator:(a)Statement from UST owner; c-e Monthly ins ection; Emto ee trainin <br /> .24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638 a) Annual line leak detector test (MI) <br /> 26 HSC 25284.2 Annual spill containment testing <br /> 27 CCR 2636 4 Annual line tightness test Ml <br /> 28 CCR 2661 Repair for tanVpiping has had ti mess test M2 <br /> 29 CCR 2643 e Biennial tightness test of Eavity piping(pre-January 1, 1984 <br /> 30 CCR 2643'd Triennial line test for conventional suction 2ipjtig(pre-January1, 1984 Ml <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Pennit to repair UST system <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 34 HSC 2529$ Permit to t orarily close UST s tem <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299(a)(9) Disabling leak detection devices <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> Septic system: <br /> ❑Serves>_20 people/day <br /> RECEIVED BY: TITLE: ❑Receives other than sanitary waste <br /> fJ Other disposal methods: <br /> h ❑Dry wells/French Drains <br /> FI4D 23-02-002 <br />