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SAN JOAQUIN COUNTY <br /> N 9 <br /> ENVIRONMENTAL HEALTHDEPARTMENTPyjj _3l _ <br /> 600 East Main Street,Stockton,California 95202-3 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.s' ov.or eh,,,,d��QQ <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM I S TION REPORT <br /> Faacil�ity'name: Designated Operator: Innsspecttion Date: <br /> Q�l ✓ V*wram <br /> A S�n f-1R_tty CJ'I Z 6 <br /> Facility address- � � T UST. <br /> s l�'V� Product <br /> Facility Cont ct: Title: Phone: Si <br /> (�(� , <br /> Yt �) — 2- � <br /> Monti( r'ng Panel: Pi mg system: Overfill prevention: <br /> N. ressurized ❑Suction ❑Gravity echanical ❑Audible/visual <br /> Inspection type: ---fiolations: �/ <br /> outine ❑Monitorin Certification ❑Installation ❑Other: ❑M1-RDetect p(M2-RPrev 0 M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V R V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test erformed <br /> 3 CCR 2711 b)& c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form) <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter b <br /> 5 CCR 2632 b Monitoring Program(Monitoring&Response Plan)is current and approved by the local agency. <br /> 6 CCR 2712 i) Monitoring Ian is onsite. <br /> 7 CCR 2712 b Maintenance&monitoring records M1 <br /> 8 CCR 2643 d Daily monitoring of suction piping(pre-January, 1, 1984) <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present (M1) <br /> I 1 CCR 2630 d UST system monitoring equipment is properly located to detect a leak (M1) <br /> 12 HSC 25291 b UST system monitoring equipment isoperational (M2) <br /> 13 CCR 2636(t)(1) Continuous monitoring system for underground piping&UDC is present M1 <br /> 14 CCR 2631 a) Primary containment is product tight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in secondary piping flow to a collection sum <br /> 17 HSC 25291 Line leak detector(s) are installed M1) <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&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases (M1) <br /> e 23 CCR 2715 Designated Operator: tatement from UST owner; (c-e)Monthly inspection;(fl Employee trainin <br /> 24 CCR 2638 a Annual monitoring certification ' -(), <br /> 25 CCR 2638 a) Annual line leak detector test 0'; (M 1) <br /> 26 HSC 25284.2 Annuals ill containment testing 1 <br /> 27 CCR 2636(f)(4) Annual line tightness test Ml) <br /> 28 CCR 2661 Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643 a Biennial tightness test of gravity piping(pre-January 1, 1984 <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping( re-Janua I, 1984) (M1) <br /> 31 1 HSC 25292.5 Double walls stem located within 1000'of public well-ELor <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 temporarily close UST system <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 IW i PHONE: r(CUIC Septic system: <br /> Serves>_20 people/day <br /> RECEIVED BY: / TITLE: —Receives other than sanitary waste <br /> va,( Other disposal methods: <br /> Dry wells/French Drains <br /> EHD 23-02-002 REV 05/07 <br />