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SAN JOAQUIN COUNTY <br /> ONVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3ra Floor,Stockton,CA 95202'2708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjov.or <br /> UNDERGROUND STORAGE TANK UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> NNCA <br /> Facility address: UST# <br /> gLbe,\ <br /> Product <br /> Facility Contact: Title: i®Phone: <br /> G tA <br /> Monitoring Panel Piping system: Overfill prevention: <br /> ❑Pressurized WSuction ❑Gravity L'7 Mechanical ❑Audible/visual <br /> ection type: Violations: <br /> Routine onitoring Certification ❑Installation ❑Other: ❑M1-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section <br /> V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR 2637SecondTj containment test performed <br /> 3 CCR 2711 & c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br /> 4 HSC 25292.2 Certification of financial responsibility and CPO letter <br /> 5 CCR 2632(c)(2D Monitoring&res onse plan is current and filed with the local a enc <br /> 6` CCR 2712(i) Moni Dring&response plan is onsite' <br /> 7 CCR 2712 b Maintenance&monitoring records Ml <br /> 8' CCR 2643(d) Daily monitorin ofsuction' i itire-Janu° , 1, 1984) <br /> 9 HSC 25292.1 UST system iso erated to prevent unauthorized release <br /> 10 CCR 2632'(c)(Q UST monitoring s stern is present Mi <br /> 11 CCR 2630(d) UST system monitoring equipment is properly located to detect a leak Ml <br /> 12 HSC 25291 UST system monitoring a ui ent isoperational M2 <br /> 13 CCR 2636 1 Continuous monitoring system for underground 2iging&UDC is present l <br /> 14 CCR 2631 a Pri=containment is pmduct tight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in secondary pipingflow to a collection sum <br /> 17 HSC 25291 Line leak detectors are installed l <br /> 18 CCR 2635 1 Sill container ( 2 <br /> 19 CCR 2635(b)(2) Overfill prevention system M2 <br /> 20 CCR 2636'(a) Conventional suction pi in 'shall have continuous monitorin &2°containment <br /> 21 1 HSC 25291 (e) Water in 20 containment analyzed& ro erly disposed of <br /> 22 CCR 2650 Rec fing/repoTting of unauthorized releases' ! Mi <br /> 23 CCR 2715 Designated O erator:(a)Statement from UST owner; (c-e)Monthly inspection; f)Em to ee training <br /> 24 CCR 2638(a2 Annual monitoring certification <br /> 25 CCR 2638 a Annual line leak detector test ( I) <br /> 26 HSC 25284.2 Annuals ill containrnent"testin <br /> 27 CCR 2636 4 Annual line tightness test l <br /> 28 CCR 2661 Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643 e Biennial ti hmess test of gravity pipingre-Jana 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction i`in (pre-January 1, 1984` (M1 <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 1 HSC 25286 a Permit to alter monitoring system <br /> 34 HSC 25298 Permit to temporarily close UST s stem <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299(a)(9) Disablina leak detection devices <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other: <br /> EHD INSP OR: PHONE: UIC <br /> Septic system: <br /> El Serves>_20 people/day <br /> EI Y TITLE: ❑Receives other than sanitary waste <br /> Other disposal methods: <br /> 0 Dry wells/French Drains <br /> FHD 23-02-002 <br />