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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3 d Floor, Stockton, CA 95202-2708 <br />Telep one: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.or /g ehd <br />UNDERGROU STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />acility name: <br />Designated Operator: <br />Inspection Date: <br />Facility address: <br />UST # <br />Product <br />Facility Contact: <br />Title: Phone: <br />Monitoring <br />Panel: <br />Piping syst m: <br />❑ Pressuriz d ❑ Suction ❑ Gravity <br />Overfill prevention: <br />❑ Mechanical <br />❑ Audible/visual <br />Inspection type: <br />❑ Routine [] Monitoring Certificatio ❑ Installation ❑ Other: <br />Violations: <br />❑ MI-RDetect <br />❑ M2-RPrev ❑ M-3 Both <br /># <br />Code Section <br />VIOL TION(S) HSC=California Health & Safety Code; CCR=California Code of Regulations V R V=Violation; RV=Re eat Violation V <br />1 <br />HSC 25284 <br />Permit to erate <br />2 <br />CCR 2637 <br />Secondarf containment test performed <br />3 <br />CCR 2711 (b) & (c) <br />Current Qnified Program Consolidated Forms on file with EHD (Facility and tank form) <br />4 <br />HSC 25292.2 <br />Certificate n of financial responsibility and CFO letter <br />5 <br />CCR 2632 (c)(2)(D) <br />Monitori t; & response plan is current and filed with the local agency <br />6 <br />CCR 2712 (i) <br />Monitori4 &res onse plan is onsite <br />7 <br />CCR 2712 (b) <br />Maintena ce & monitoring records <br />Ml <br />8 <br />CCR 2643 (d) <br />Daily mo itoring of suction piping (pre -January, 1, 1984) <br />9 <br />1 HSC 25292.1 <br />UST s ste isoperated to prevent unauthorized release <br />10 <br />CCR 2632 (c)(2) <br />UST montoring system is present <br />(M1) <br />11 <br />CCR 2630 (d) <br />UST s ste monitoring equipment is properly located to detect a leak <br />(M1) <br />12 <br />HSC 25291 (b) <br />UST s ste monitoring equipment isoperational <br />M2) <br />'3 <br />CCR 2636 f)(1) <br />Continuo monitoring system for underground piping & UDC is present <br />M1 <br />4 <br />CCR 2631 a) <br />Primary c ntainment is product tight <br />15 <br />HSC 25291 (a)(2) <br />Secondar containment for UST is tight <br />16 <br />CCR 2636 (c)(1) <br />All releas in secondary piping flow to a collection sum <br />17 <br />HSC 25291 (f) <br />Line leak etector(s) are installed <br />(M1 <br />18 <br />CCR 2635 (b)(1) <br />Spill cont finer <br />(M2) <br />19 <br />CCR 2635 (b)(2) <br />Overfill prvention system <br />M2 <br />20 <br />CCR 2636 (a) <br />Conventioilial suction piping shall have continuous monitoring & 2° containment <br />21 <br />HSC 25291 (e) <br />Water in 2t containment analyzed & properly disposed of <br />22 <br />CCR 2650 <br />Recordinghreporting of unauthorized releases <br />Ml <br />23 <br />CCR 2715 <br />Desi nate Operator: (a) Statement from UST owner; (c -e) Monthly inspection; (f) Employee training <br />24 <br />CCR 2638 a <br />Annual mobitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test <br />(M1) <br />26 <br />HSC 25284.2 <br />Annuals i 1 containment testing <br />27 <br />1 CCR 2636 (f)(4) <br />nual lin tightness test <br />(M1) <br />28 <br />CCR 2661 (f) <br />EREe air for ank/piping has had tightness test <br />(M2) <br />29 <br />CCR 2643 (e) <br />Biennial ti htness test of gravity piping(re-Januar 1, 1984) <br />30 <br />CCR 2643 (d) <br />Triennial li a test for conventional suction piping (pre -January 1, 1984) <br />(M1 <br />31 <br />HSC 25292.5 <br />Double wal system located within 1000' of public well-ELD <br />32 <br />CCR 2661 <br />Permit to r air UST system <br />33 <br />1 HSC 25286 (a) <br />Permit to al1tcr monitoring system <br />34 <br />HSC 25298 (b) <br />Permit to to2porarily close UST system <br />35 <br />HSC 25298 (c) <br />Permit to cl se UST system <br />36 <br />HSC 25299 (a)(9) <br />Disabling I ak detection devices <br />37 <br />HSC 25298 a) <br />Illegal aban onment of UST system <br />38 <br />Other: <br />EHD INSPECTOR: <br />- -- <br />PHONE: <br />- - - - - <br />UIC <br />Septic system: <br />Serves >_20 people/day <br />Receives other than sanitary waste <br />Other disposal'meth(ids: <br />Dry wells/French Drains <br />.ECEIVED BY: <br />TITLE: <br />FHD 23-02-002 <br />