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SAN JOAQUIN COUNTY <br /> OVIRONMENTAL HEALTH DEPARTMENT , <br /> 304 East Weber Avenue,3`d Floor, Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.or <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Insection Date: <br /> �y\N)c ':")o o s c \\�� os <br /> Facility address: UST# a <br /> \50\ J�� T�J� '0-0P<O o \ <br /> Product o17` <br /> Facility Contact: Title: Phone: S <br /> %0 0�\ ov, <br /> Aonitoring Panel: Pi ing system: 07(fill prevention: <br /> LW:>-3bo I Pressurized ❑Suction ❑Gravity VMechanical ❑Audible/visual <br /> 7ection type: Violations: <br /> outine ((Monitoring Certification ❑Installation ❑Other: ❑Ml-RDetect ❑M2-RPrev M-3 Both <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section <br /> V=Violation;RV=Re eat Violation `, <br /> 1 HSC 25284 Permit tooperate <br /> 2I CCR 2637 Secondary containment test performed' <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 <br /> 5 CCR 2632(c)(2)(D) Monitoring&response plan is current and filed with the local agency <br /> 6 CCR 2712(i) Monitoring&response plan;,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 (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 equipment is operational M2 <br /> 13 CCR 2636 1) 1 Continuous monitoring system for underground piping&UDC is present Ml <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 pipingflow to a collection sum <br /> 17 HSC 25291 ( Line leak detector(s)are installed Ml <br /> 18 CCR 2635(b)(1) Spill container M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system (N12 <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized'releases Ml <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly inspection;(f)Employee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (Ml) <br /> 26 HSC 25284.2 Annual spill containment testing <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(pre-January 1, 1984) (Mi) <br /> 31 HSC 25292.5 Double walls stem located within 1000'ofpublic well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286 a Permit to alter monitorin system <br /> 34 HSC 25298 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 /> D INS PHONE: UIC <br /> •� 7 Septic system: <br /> Serves>_20 people/day <br /> RE TITLE: L Receives other than sanitary waste <br /> .o I Other disposal methods: <br /> C t t e ❑Dry wells/French Drains <br /> F,HD 23-02-002 <br />