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0 SAN JOAQUIN COUNTY 10 <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.orci/ehd/unitiii.html <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility name: Inspection <br />Date/ <br />Facility address: <br />Facility contact: Title: Phone: <br />Monitoring panel: Piping system: Overfill prevention: <br />[I Gravity )Wechanical(06P. [I Audibie/visuai <br />ressurized El Suction <br />InVection type: Violations. <br />EHD 23-02-002 REV 12109 Page 1 <br />UST INSPECTION REPORT <br />On site Technician's Name: <br />ICC Service Technician Exp. Date: <br />Manufacturer's Training: <br />VAA K <br />Code Section i <br />11 <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=California Code of Regulations <br />V=Violation; RV=Repeat Violation - <br />MMSWOJM7%M��� <br />No permit to operate <br />NEW 1111WIN IlMall MO 0 1 1* <br />-Current Unified Program Consolidated Forms not on file with the EHD (Facility and tank form) <br />MORMON <br />NOW 11111111M.10.11 ff-ftl IM $I =01" as *2 <br />CCR 2712(b) <br />Daily monitoring of suction pipin (pre -January 1, 1984) not performed <br />UST system is not operated to prevent unauthorized release, including spills and overfills <br />W -111M. 7,11111111M <br />CCR 2636(f)(1) <br />Primary containment is not product tight <br />MillreTelzW*�IIIIIIIIIIII� <br />All releases in secondary piping do not flow to a collection sump <br />IF <br />CCR 2635(b)(1) <br />-Spill container not installed, failed to contain a minimum capacity of five gallons, or failed to provide (M2) <br />11 <br />a means to keep the spill container emp <br />0 091 I.M. <br />NM- M.'r 611MIL411011 all "all 11.1-M <br />Unauthorized release that(c) d—id n-6-t–es -cape secondary containment and cleaned up within eight hours (M 1) <br />was not recorded; (e) escaped secondary containment, not cleaned up after eight hours, or a sudden loss of <br />product was not reLorted to the EHD within 24 hours <br />•Failed <br />to inform the EHD of a change of designated operator within 30 days <br />Wgrgablis <br /># 61557mol 0 0 <br />23c <br />CCR 2715(c), (d), (e) <br />'OrEWTOR <br />-664 - - <br />111W61,11 67 11"11,4010,61W <br />JS 1. 1 1 11 <br />23d <br />CCR 2715(f) <br />, all , <br />EHD INSPECTOR: <br />L <br />RECEIVED B <br />EHD 23-02-002 REV 12109 Page 1 <br />UST INSPECTION REPORT <br />