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SAN JOAQUIN COUNTY <br /> IRONMENTAL HEALTH DEPARTMENT <br /> 304 East eber Avenue,3rd Floor, Stockton,CA 95202-2 <br /> Telephone: (209)468-3420 Fax:(209)468-3433 Web:www.sjgov.ore/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> ekt`rs L-t-cvof;L tcs.Qae B Tt Cb-2o Vla <br /> Facility address: UST# t Z -3 <br /> I1t05 C^t XIPCe-r'l0 Product <br /> Facility Contact: Title: Phone: <br /> 60ey 2-o9 830 int <br /> Monitoring Panel: Pt Ing system: Overfill prevention: <br /> Pressurized C Suction C Gravity Mec ical C Audible/visual <br /> Inspection type: Vi tions: <br /> C Routine C Monitoring Certification C Installation C Other: Ml-RDetect C M2-RPrev C M-3 Both <br /> # Code Section <br /> VIOLATIONS) HSC=California 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 2637Secondary containment test performed ✓ <br /> 3 CCR 2711 b & c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form >G <br /> 4 .HSC 25292.2 Certification of financial responsibility and CFO letter ✓ <br /> 5 CCR 2632 c 2 D Monitorin &response plan is current and filed with the local agency <br /> 6 CCR 2712.(i) Monitoring&response plan is onsite ✓ <br /> 7 CCR 2712 6 Maintenance&monitoring records MI ✓ <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 I CCR 2630 d UST system monitoring equipment is properly located to detect a leak M] <br /> 12 HSC 25291 b UST system monitorin 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 (MI) <br /> 18 . 1 CCR 2635(b(1) Spillcontainer (M2 <br /> 19 CCR 2635(b)(2) Overfill prevention system M2 <br /> 20 '. CCR 2636(a) Conventional suction piping shall have continuous monitoring&2 containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/rcporting of unauthorized releases" MI <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 (Ml) / <br /> 26. HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test Ml <br /> 28. CCR 2661 Repair for tank/piping has had tightness test M2 <br /> 29 CCR 2643 a Biennial tightness test of gravity pipingre-Jana 1, 1984 <br /> 30 CCR 2643(d) Triennial line test for.conventional suction piping(pre-January1, 1984) (Mi) <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 Permit to temporarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299 a 9 Disablin leak detection devices <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 1 Other: <br /> EHDINSPECTOR: PHONE: UIC <br /> Septic system: <br /> O Serves 2:20 people/day <br /> IVED BY: TITLE: D Receives other than sanitary waste <br /> Other disposal methods: <br /> C Dry wells/French Drains <br /> EHD 23-02-002 <br />