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• SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton,CA 95202=2708 <br /> Telephone: (209)468-3420 Fax:(209)468-3433 Web:www.sieov ory(ehd <br /> Facility name: UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Designated Operator: Inspection Date: <br /> v� ? TP(4cttJJ G Ti W L3uN <br /> Facility address: <br /> OST# <br /> 7611 S ARPhe-F 0&41 Z - <br /> Facility Contact: Title: Phone: Product <br /> ' <br /> MARK <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> W 9hressurized ❑Suction ❑Gravity L9 AAechanical ❑Audible/visual <br /> IRS ection type: / Violations: <br /> L7?utine MT1onitorin Certification ❑Installation ❑Other: ❑MI-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit too este <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 6 & 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) 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 Ml <br /> 8 CCR 2643 d Daily monitoring of suction piping(prc-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 /> H 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 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 piping flow to a collection sum <br /> 17 HSC 25291 Line leak detectors are installed Ml <br /> 18 1 CCR 2635(b)(1) Spill container M2 <br /> 19 1 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&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases Ml <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 (MI) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test MI <br /> 28 CCR 2661 (f) Repair for tank/piping has had tightness test M2 <br /> 29 CCR 2643 e Biennial tightness test of gravity piping(pre-January 1 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping( re-Jana 1, 1984) (Mill <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to re air UST system <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 34 HSC 25298 Permit to temporarily close UST system <br /> 35HSC 21D9l 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 /> NA / p�3 Septic system: <br /> O d Serves 220 people/day <br /> RECEIVED BY: TITLE: C Receives other than sanitary waste <br /> Other disposal methods: <br /> -./`•e �/LDry wells/French Drains <br /> P.HD 23-02-002 <br />