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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org�ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> t4 <br /> Facil*t address: <br /> UST# <br /> 9533ck- 'Product <br /> Facility Contact: Title: Phon —7 <br /> Monitoring Panel: Piping system. <br /> Overfill prevention: <br /> >gressurized 11 Suction El Gravity ><Mechanical 2�El Audible/visual <br /> Inspection type: Violations: <br /> I <br /> Routine 24!onitoring Certification El Installation El Other: El M I-RDetect El M2-RPrev El M-3 Both <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomidf Regulations V <br /> # R <br /> # Code Section a Coe oReguV=Violation;RV=Repeat Violation V <br /> I HSC 25284 Permit toogerate <br /> 2 CCR 2637 Seconds containment test performed If <br /> 3 CCR 2711 (b)&(c) Current Unified Program Consolidated Forms on file with EHD Facilit and tank form) <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632(b) MonitorinE Pro ram M)nitorin &Res2onse Plan)is current and approved by the local agenc <br /> 6 CCR 2712(i) Monitorin plan is onsite. <br /> 7 CCR 2712(b) Maintenance&monitoring records (M <br /> 8 CCR 2643(d) Daily monitoring of suction piping(pre-Januaa, 1, 1984) <br /> 9 HSC 25292.1 UST s stem iso erated to revent unauthorized release <br /> 10 CCR 2632 c)(2) UST monitoring system is gresent (M 1) <br /> I I CCR 2630(d) UST system monitoring eciui2ment is 2ro2erly locatedto detect a leak (M 11) <br /> 12 HSC 25291 (b) UST system monitoring equipment isoperational (M2) <br /> 13 CCR 2636(D(I) Continuous monitorinE system for under round piping&UDC is present <br /> 14 CCR 2631 (a) Primary containment is product ti ht <br /> 15 HSC 25291 a)(2) Secondary containment for UST is ti ht <br /> 16 CCR 2636 ic)(1) All releases in secondary piping flow to a collection sump <br /> 17 1 HSC 25291 Line leak detectors are installed (M 1) <br /> 18 CCR 2635(b)(1) Spill container (M2) <br /> 19 CCR 2635 b)(2) Overfill prevention system (M2) <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2'containment <br /> 21 HSC 25291 (e) Water in 2'containment analyzed&Rro2erly disposed of <br /> 22 CCR 2650 RecordinE/re porting of unaut4QdzgA releases (M 1) y <br /> 23 CCR 2715 Designated Operator:(5)­Statement from UST owner, (c- <br /> e)Monthly ins ection;(f) Em2loyee training <br /> 24 CCR 2638 a) Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (M1) <br /> 26 HSC 25284.2 Annual s2ill containment testing <br /> 27 CCR 2636 4) Annual line tightness test (M1 <br /> 28 CCR 2661 f) E2eair for tank/2i2inhas had tiElitness test (M2) <br /> 29 CCR 2643(el Biennial tightness test of gravjt i in re-Januaa 1, 1984� <br /> 30 CCR 2643(d) Triennial line test for conventional suction 2iping(pre-January 1, 1984) (M1) <br /> 31 HSC 25292.5 Double wall system located within 1000"of public well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286(a) Permit to alter monitoring system <br /> 34 HSC 25298(b) Permit to tem2orarily close UST system <br /> 35 1 HSC 25298(c) Permit to close UST system <br /> 36 HSC 25299(a)19) Disabling leak detection devices <br /> 37 HSC 25298 1a) Illegal abandonment of UST system <br /> 38 Other: <br /> EH13 INSZ7 <br /> PH PIE: UIC <br /> 'To <br /> Sotic system: <br /> —Serves!-20 people/day <br /> LR E C3TD�By- el TITLE: —Receives other than sanitary waste <br /> Other disposal methods: <br /> Dry wells/French Drains <br /> GUM <br /> EHD 23-02-002 REV 05/07 <br />