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r r • 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 /> rrvllG& L►�21�0►2 I��iv A►WA2i 7/�slo8 <br /> Facility address: UST# 197 s'ns(/0-0,5 C. kj " M 'Pmduet G f- <br /> - II <br /> Facility Contact: Title: Phone: <br /> t>o)wJ19 eft€ m 938-76 7q- <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> 6)(('9R-60 I lBlfressurized C Suction C Gravity B?dechanical C Audible/visual <br /> Inspection type: Violations: <br /> C Routine 2/MonitoringCertification C Installation C Other: 1 C MI-RDetect C M2-RPrev C M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC-California Health&Safety Code;CCR-California Code of Regulations V R V=Violation;RV-Repeat 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 b Monitoring Program(Monitoring&Response Plan)is current and approved by the local agency. <br /> 6 CCR 2712 i) Monitoring Ian is onsite. <br /> 7 CCR 2712 b Maintenance&monitoring records Ml <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 (Ml) <br /> I 1 CCR 2630 d UST system monitoring equipment is properly located to detect a leak M l) <br /> 12 HSC 25291 b UST s stem monitoring equipment isoperational (M2) <br /> 13 CCR 2636 l 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 detector(s) are installed M 1) <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 2°containment analyzed&property disposed of <br /> 22 CCR2650 Recording/re orting of unauthorized releases MI) <br /> 23 CCR 2715 Designated Op erator:(a)Statement from UST owner; (c-e)Monthly inspection; t) Employee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638 a) Annual line leak detector test (M 1) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 41_ Annual line tightness test M1) <br /> 28 CCR 2661 f) Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643 a Biennial tightness test of gravity pipingre-Janus 1, 1984 <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping( re-Janus I, 1984) (M l) <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 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 /> EHD INSPECTOR: PHONE: UIC <br /> m /(�r tA l�g_ 1(4-141 Septic system: <br /> Serves 220 people/day, <br /> RECEIVED BV: TITLE: - Receives other than sanitary waste <br /> Other disposal methods: <br /> �\ —Dry wells/French Drains <br />