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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.sisov.orwehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> k2i . IQ�Nk21 �� � <br /> Facility address: UST# ' , <br /> Product <br /> Facility Contact: Title: Phone: <br /> Monitoring Panel: Pip, g system: Overfill prevention: <br /> Pressurized ❑Suction ❑Gravity ❑Mechanical ❑Audible/visual <br /> Inspection type: Violations: <br /> _11 Routine ❑Monitoring Certification ❑Installation ❑Other: ❑MI-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATIONS) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R V=Violation;RV=Re eat Violation V <br /> I HSC 25284 Permit tooperate <br /> 2 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 6 Monitoring Program(Monitoring&Response Plan is current and approved by the local agency. <br /> 'u•'` <br /> 6 CCR 2712 i) Monitoring Ian is onsite. <br /> 7 CCR 2712 6 Maintenance&monitoring records Ml v <br /> 8 CCR 2643 d Daily monitoring of suction piping(pre-January, I, 1984 <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present Ml) <br /> 1 I CCR 2630 d UST system monitoring equipment is properly located to detect a leak MI <br /> 12 HSC 25291 6 UST system monitoring equipment isoperational (M2) <br /> 13 CCR 2636 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 detectors are installed M 1) <br /> 18 CCR 2635(b)(1) Sill container (M2) <br /> 19 CCR 2635(b)(2) Overfill reventionsystem (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 CCR2650 Recording/reporting of unauthorized releases t M1) <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Month!y inspection;(t)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 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test Ml) <br /> 28 CCR 2661 R air fort k/ i in has had ti htness test (M2) <br /> 29 CCR 2643 a Bien ;; <br /> t htness test of gravity pipingre-Jana 1, 1984 <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping(pre-January I, 1984) (M 1) <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to repair UST system t11; e' <br /> 33 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(a)(9) Disabling leak detection devices <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other: <br /> END INSPECTOR: PHONE: UIC <br /> 469 - Z;4 ?Cl Septic system: <br /> C Serves 2:20 people/day <br /> RECEIVE6B : / TITLE: `Receives other than sanitary waste <br /> Other disposal methods: <br /> Dry wells/French Drains <br />