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4 • 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.sigov.ore/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> E MILS /-UM MAW kNk'LI ZS'/Or <br /> Facility address: UST# h �- ♦ , <br /> [�}6 S (i/f►�OI(A S — <br /> Product <br /> Facility Contact: 'fide: Phone: 17 <br /> lto NNA �IID� wtc�cn 43Sr — 7 c�- <br /> Monitoring Panel: Pipi g system: Overfill prevention: <br /> S141(—4 N.. Issurized ❑Suction ❑Gravity ❑Mechanical ❑Audible/visual <br /> I <br /> ection type: Violations: <br /> ZLoutine ❑Monitoring Certification ❑Installation ❑Other: ❑MI-RDetect ❑M2-RPrev 0 M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC=Catifomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> V <br /> V=Violation; RV=Repeat Violation <br /> I HSC 25284 Permit tooperate <br /> 2 CCR 2637 Second a 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 /> 6 CCR 2712 i) Monitoring Ian is onsite. <br /> 7 CCR 2712 6 Maintenance&monitoringrecords (MI) <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 (M 1) <br /> I I CCR 2630 d UST system monitoring equipment is properly located to detect a leak M l <br /> 12 HSC 25291 6 UST system monitorin equipment isoperational (M2) <br /> 13 CCR 2636 I 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 i ing flow to a collection sum <br /> 17 HSC 25291 Line leak detectors are installed M1) <br /> 18 CCR 2635(b)(1) Sill container (M2) <br /> 19 CCR 2635(b)(2) Overfill Preventionsystem (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&property disposed of <br /> 22 CCR 2650 Recordin reporting of unauthorized releases (M 1) <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly inspe Em to ee 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 4 Annual line ti chtness test Ml) <br /> 28 CCR 2661 Re air for tank/piping has had tightness test (M2) <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 I, 1984) (Ml <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to repair UST system tw Val, <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 /> 469 Z�.3 Lj Septic system: <br /> S Serves 20 people/day <br /> RECEIV B TITLE: -Receives other than sanitary waste <br /> __ Other disposal methods: <br /> 14-1 -Dry wells/French Mains <br /> can ncv nsm, <br />