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DATE 7/g/02 <br />SAN JOAQUIN COUNTY PR# <br />ENVIRONMENTAL HEALTH DEPARTMENT PAGE ! a 2 <br />304 E. Weber Ave., Third Floor, Stockton, CA 95202 <br />(209) 468-3420 <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility Name Coun�r%-4 -5 dpl ffilm AAIP Facility Address l K g 71 Al y`"Y <br />Facilty Contact Ar`1 Bt,ra fN Title . 0 VJ4 QZ- Phone # <br />UST# Product UST#_Product UST# Product UST# Product <br />Overfill Prevention: ❑ Audible/Visual ❑ Mechanical Monitoring Panel: <br />Piping System: ❑Gravity ❑Pressure [3 Suction <br />Violations: ❑ Minor ❑ Major <br />Automatic Pump Shut Down Satisfies CCR 2636 : ❑ Yes ❑ No Dispenser Pan: ❑ Yes ❑ No <br />INSPECTION TYPE: )CRoutine ❑Monitoring Certification ❑Complaint ❑Install ❑Removal ❑Repair/Upgrade <br />COMPANY NAME: <br />TECHNICIAN NAME: PHONE: <br />The above facility is not in compli fo i is he following <br />Regulations (CCR): & Safety Code (HSC) and/or <br />Cal <br />1 <br />HSC 25284 <br />Permit to operate <br />2 <br />CCR 2637 <br />Secondary contsting (6 <br />23CCR 2630 (d) <br />Annual monitoring certification <br />month month) <br />or <br />3 V CCR 2711(b) & (c) <br />Current State Forms A & B <br />4�HSC <br />25292.2 <br />Certification of financial <br />25 CCR 2643 (d) <br />Triennial tightness test of <br />responsibility and letter from <br />suction piping that is not <br />chief financial officer <br />5 <br />CCR 2630 (d) <br />Continuous monitoring system <br />piping that is not continuously <br />for UST system <br />6 <br />CCR 2636 (c)(1) <br />All releases in secondary piping <br />system <br />28 CCR 2661 <br />flow to a collection sump <br />7 <br />HSC 25291 (e) <br />Water in secondary (2°) cont <br />8 <br />HSC 25291 (f) <br />Automatic line leak detector(s) <br />9 <br />CCR 2636 (f)(1) <br />Continuous monitoring system <br />system <br />32 HSC 25298 (c) <br />for underground piping <br />10 <br />CCR 2632 (c)(2) <br />Continuous monitoring system <br />properly disposed of <br />34 CCR 2640 (e) <br />for UST <br />11 <br />HSC 25291(a)(2) <br />Secondary containment for <br />36 H&SC 25299(a)(9) Disabling leak detect. device <br />37 <br />UST is tight <br />12 <br />CCR 2636 (f)(1) <br />Continuous monitoring system <br />for dispenser system <br />13 <br />CCR 2635 (b)(1) <br />Spill container <br />14 <br />CCR 2635 (b)(2) <br />Overfill prevention system <br />15 <br />CCR 2631 (a) <br />Primary containment is product - <br />tight <br />16 <br />HSC 25292.1 <br />UST system is operated to <br />prevent unauthorized release <br />17 <br />CCR 2650 <br />Recording/reporting <br />2632 (d) <br />unauthorized release <br />Monitoring & response plan <br />18 <br />19 <br />�LCCR <br />CCR 2712 (i) <br />Monitoring & response plan is <br />on site <br />EHD INSPECTOR: KA V""' <br />RECEIVED BY: TITLE: <br />icTa1NCP 1-v 3(5/02) <br />20 V CCR 2712 (b) <br />Maintenance & monitoring <br />! <br />21 V CCR 2636 (f)(4) <br />records <br />Annual line tightness test <br />22V—CCR 2630 (d) <br />Annual line leak detector test <br />23CCR 2630 (d) <br />Annual monitoring certification <br />24 CCR 2643 (d) <br />Daily monitoring of suction <br />piping that is not continuously <br />monitored <br />25 CCR 2643 (d) <br />Triennial tightness test of <br />suction piping that is not <br />continuously monitored <br />26 CCR 2643 (e) <br />Biennial tightness test of gravi <br />piping that is not continuously <br />monitored <br />27 CCR 2662 <br />Upgrade requirements for US' <br />system <br />28 CCR 2661 <br />Permit to repair UST system <br />29 HSC 25286 (a) <br />Permit to alter monitoring <br />system <br />30 HSC 25298 (a) <br />Illegal abandonment of UST <br />31 HSC 25298 (b) <br />system <br />Permit to temporarily close U <br />system <br />32 HSC 25298 (c) <br />Permit to close UST system <br />33 HSC 25291 (e) <br />Water in 20 cont analyzed an <br />properly disposed of <br />34 CCR 2640 (e) <br />Single wall component within <br />1000, of Public Well, no ELD <br />35 CCR 2635(a)(2)(A) Cathodic protection testing <br />36 H&SC 25299(a)(9) Disabling leak detect. device <br />37 <br />Violation(s) not listed above <br />1*51. PHONE: 31A- SIV <br />