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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.si2ov.orp-/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection-Date. <br /> r-&ytfj4 J ToD-1 Demdo 6/'C-/0R <br /> Facility address: UST# <br /> R4 PJ PON <br /> ,- Product S <br /> Facility Contact: Title: Phone: 2'i Jr' <br /> G <br /> - 11� -7 ru <br /> ki CAA>0 ZUW?-0r&1R0 ro#mw "I q-1 q- mt- <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> TZ S -'Z.C'u I El Suction El Gravity mechanical 11 Audible/visual <br /> Inspection type, Violations: <br /> outine WKonitoring Certification El Installation El Other: El M I-RDetect El M2-RPrev 11 M-3 Both <br /> # Code Section VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> V=Violation;RV=Repeat Violation V <br /> I HSC 25284 Permit too2erate <br /> 2 CCR 2637 Seconds containment test gerfort-ned <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 resRonsibility and CFO letter <br /> 5 CCR 2632 b) Monitoring Program Monitoring&Response Plan)is current and approved by the local agency. <br /> 6 CCR 2712(i) Monitoring plan is onsite. <br /> 7 CCR 2712 b) Maintenance&monitoring records (M 1) L", <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) --U-STmonitoring system is Eresent (M1) <br /> 11 CCR 2630(d) UST system monitoring equipment is 2ro2erly located to detect a leak (M1) <br /> 12 HSC 25291 b) UST s stem monitoring equipment isoperational (M2) <br /> 13 CCR 2636 l) Continuous monitoring system for underground 2i2ing&UDC is present (M 1) lid <br /> 14 CCR 2631 (a) Prima a 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 pi2ing flow to a collection sump <br /> 17 HSC 25291 Line leak detector(s)are installed (M 1) <br /> 18 CCR 2635 bI) Spill container (M2) <br /> 19 CCR 2635(b 2) Overfill prevention system (M2) <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitorinTg&2'containment <br /> 21 HSC 25291 (e) Water in 2'containment analyzed&2ro2crIX disposed of <br /> 22 1 CCR 2650 Recording/re 2orting of unauthorized releases <br /> 23 CCR 2715 Designated 02erator:(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 (M1) <br /> 26 HSC 25284.2 Annual s2ill containment testing <br /> 27 CCR 2636(D 4) Annual line tightness test <br /> 28 1 CCR 2661 (f) Repair for tank/piping has had tightness test <br /> (M2) <br /> 29 CCR 2643(e) Biennial tightness test of gravity piping(2re-Janus!j 1, 1984) <br /> 30 CCR 2643(d) Triennial line test for conventional suction gi ii ( re-Janus a 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 HSC 25286(a) Permit to alter monitoring system <br /> 34 1 HSC 25298(b) Permit to temporarily close UST system <br /> V35 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 /> 0 <br /> 38 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> ®� -3q-?q Septic system: <br /> -Serves 2�20 people/day <br /> RD TITLE: -Receives other than sanitary waste <br /> e� ,/. <br /> Other disposal methods:7q;4i�� r I-Dry wells/French Drains <br /> u�' <br /> EHD 23-02-002 REV 05/07 <br />