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SAN JOAQUIN COUNTY <br /> 600*�VIRONMENTAL HEALTH DEPARTMENT <br /> Main Main Street, Stockton, California 95202-3:129 <br /> Telephone: (209)468-3420 Fax: (209)468-3433 Web:www.sigov.org/ehd <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facilityname: <br /> `t ' Designated Operator:i, <br /> Inspection <br /> DaVOIis U V + 6 "�Q�� <br /> p <br /> Facility address: UST# �� L` UO / UYA'fk /o � r-"W'OIG6- 2V <br /> Facility Contact: Title: Phone: 'Product <br /> E kd tG K3 X 767 L� <br /> Mo i oNng P nel: iping system: Overfill prevention: <br /> G ressurized 0 Suction 0 Gravity 0 Mechanical 0 Audible/visual <br /> In pection type: Violations: <br /> Routine onitodng Certification 0 Installation 0 Other: 0 M1-RDetect 0 M2-RPrev ❑M-3 Both <br /> # Code Section VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V R <br /> V=Violation; RV=Re eat Violation V <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR 2637 Seconda containment test Performed <br /> 3 CCR 2711 b & c Current Unified Pro ram 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 b Monitorin Program(monitoring&Response Plan is current and approved by the local agency. <br /> 6 CCR 2712 i Monitorinq 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 (M1) <br /> 11 CCR 2630 d UST system monitoring a ui ment is properly located to detect a leak PAI <br /> 12 HSC 25291 b UST system monitoring equipment isoperational (PAI) <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping&UDC isresent 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 pipingflow to a collection sum <br /> 17 HSC 25291 Line leak detectors 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&20 containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases M1 <br /> 23 CCR 2715 Designated Operator: a Statement from UST owner; (c-e)Monthly inspection; 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 Annuals ill containment testin <br /> 27 CCR 2636 4 Annual line ti htness test (M1 <br /> 28 CCR 2661 Repair for tank/piping tank/pipinghas had tightness test (11012 <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 M1) <br /> 31 HSC 25292.5 Double walls stem located within 1000'of oublic well-ELD <br /> 32 1 CCR 2661 Permit to repair UST system <br /> 33 1 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 Disabling leak detection devices <br /> a 9 2 <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR: <br /> PTE:g ���� UIC <br /> 41 Septic system, <br /> o ❑Serves>20 people/day <br /> RE N D 8 TITLE: D Receives other than sanitary waste <br /> Other disposal methods- <br /> El Dry wells/French Drains <br /> EHD 23-02-002 REV 8/08 <br />