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yop9.41M..,co <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3d Floor, Stockton, CA 95202-2708 <br /> c 'P Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> 9<lFO ` }`. <br /> UNDERGROUND STORAGE TANK ST PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> Ir S r3fE3i Lr1NE kyRN f�UNG1c r,141(, -7 <br /> Facility address: UST# <br /> 60 AlelvG/C"T 1.. -"ZI 1 iicl .Product .'T'r5tr <br /> Facility Contact: Title: Phone: <br /> ll1i��l[ rn�c6as1� 4`, '-'7.iL'rC f2-�y) ilk — ly4 , <br /> Monitoring Panel: Piping system: Overfill prevention: / <br /> j/f• r (_ s ?,C,(> C}Pressurized ❑Suction ❑Gravi ©61vfechanical ❑Audible/visual <br /> Inspection type: // Violations: <br /> 13,6utine L4nitorin Certification 0Installation 0 Other: 0 Ml-RDetect 0 M2-RPrev 0 M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=Califomia Code of Regulations V R V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR 2637 Second 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(c)(2 D Monitoring&response plan is current and filed with the local agency <br /> 6 CCR 2712 i Monitoring&response plan is onsite <br /> 7 CCR 2712 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 MI <br /> I 1 CCR 2630 d UST system monitoring equipment is properly located to detect a leak Ml <br /> 12 HSC 25291 UST system monitoring equipment isoperational M2 <br /> 13 CCR 2636(f)(1) Continuous monitoring system for underground piping&UDC is present (Mi) 11 <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 piping flow to a collection sum <br /> 17 HSC 25291 f) Line leak detector(s)are installed (MI) <br /> 18 CCR 2635 1 Spill container M2 <br /> 19 CCR 2635 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 Ml <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; Lc-e)Monthly inspection; Employee rainin ✓ <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638 a Annual line leak detector test (MI) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636(f)(4 Annual line tightness test (Mi) <br /> 28 CCR 2661 Repair for tank/piping has had tightness test M2 <br /> 29 CCR 2643 a Biennial tightness test of gravity piping( re-Janu 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piRing(pre-January1, 19842Ml <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 25286a Permit to altermonitorin system <br /> 34 HSC 25298 6 Permit to temporarily close UST system <br /> _ 35 HSC 25298 c) Permit to close UST system <br /> 36 HSC 25299(a)(9)-- -Disablfng leak defection devices - - - - ---- --------- - <br /> 37 HSC 25298 a) I Illegal abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> ,�1�,.!0i,v, (,� 6 > 7 C) Srn11 system: <br /> 1 11 Serves a20 people/day <br /> RECEIVE Y: TITLE: ❑Receives other than sanitary waste <br /> l$l _ / / t' — Other Dry wells/French <br /> f�f'11r,�� G'a/tr. ❑ wells/Frrnch Drains <br /> V <br /> BHD 23-02 <br />