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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, California 95202-3029 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sm.qov.org/ehd/unitiii.htmi UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT I.... IG. bsfo wrup,&I&4 40 al tacnity contact: �R -:14k-&A Monittorring panl: V r— Rl. Inspection type: Routine Monitoring Certification lOn site Service Technician's name. Sad, AnAgAy1 # Code Section HSC=CA Health & Safety C ripmg system: /Pressurized ❑ Suction ❑ Gravity ❑ Installation I- Other: ICC exp, date: Z+ Manufac i V 1 Vic 1 HSC 25284 No ermit to o erate CCR—CA 2 1 CCR 2637 3 CCR 2711 b 4 HSC 25292.2 5 CCR 2632 b 6 CCR 2712(1) 7 CCR 2712(b) 8 Inspection date: 9 j 10 UST # C J 3 12 Product 18 18 ` 19 CCR 2635 b 2 20 CCR 2636(a) s• I MW HSC 25291(e) n......r a ._ _ ❑ Installation I- Other: ICC exp, date: Z+ Manufac i V 1 Vic 1 HSC 25284 No ermit to o erate CCR—CA 2 1 CCR 2637 3 CCR 2711 b 4 HSC 25292.2 5 CCR 2632 b 6 CCR 2712(1) 7 CCR 2712(b) 8 CCR 2643(d) 9 HSC 25292.1 10 CCR 2632(c)(2' 11 CCR 2630(d) 12 HSC 25291(b) 13 CCR 2636(#)(1) 14 CCR 2631 a 15 HSG 25291 a 16 CCR 2636 c 1 17 636 2 CCR 2636(f)(2)- 18 18 CCR 2635(b)(1) 19 CCR 2635 b 2 20 CCR 2636(a) 21 HSC 25291(e) 22 1 CCR 2650 23a CCR 271 23b CCR 271 Secondary containment: (a) test not performe notification not provided to the Environmental conductin the test Current Unified Pro ram Consolidated Forms I Current financial r ------:"lilt documents not Monitorin Program (Monitoring& Response Monitorin Ian, res onse Ian and/oro erati 17 Mechanical VAudible/visual gn�atled,gpera or: A. 1 b ar's training: 0-3t0 11 !J M1-Rl7etect C M2-RPrev ❑ M3 -both V I2 a� 1Z date: W r Iurva ' Cc R of Re ulations, V=Violation; RV=Re eat Violation V V d; (e) test report not submitted within 30 days; (f) test Health Department (EHD) at least 48 hours prior to not on file with the EHD Facilit and tank form on file with the EHD Plans is not current or approved b the EHD n ermit and all conditions not onsite Maintenance & monitoring records not maintained 3 years, cathodic protection records for 6 Y (M�) years, written performance claims pertaining to release detection systems for 5 years, or records of repairs, linings, and upgrades for the life of the tank. Monitoring records include: (1) date and time of all monitoring or sampling; (2) monitoring equipment calibration and maintenance records; (3) results of any visual observations; (4) results of sample analysis performed a lab or in the field; (5) logs of all readings of gauges or other monitoring equipment, ground water elevations, or other test results; (6) results of invent- readings and reconciliations Dail monitorin of suction i in re -Janus 1, 1984 not performed M1) UST s stem is not o erated to revent unauthorized release, includingspills and overfills Monitorin s stem is not resent in the interstitial space of a double walled UST UST monitorin a ui ment is not installed or maintained to detect a leak at the earliest opportunity(mi) ( UST monitoring system incapable of detecting leak from primary containment into secondary (M1) containment Failed to maintain a continuous monitoring system for underground piping & UDCs that activates (Mi) an audible and visual alarm or stops flow of product at the dispenser when it detects a leak Primary containment is not roduct tight Seco Idary containment for UST system is not tight All releases in secondary pipingdo not flow to a collection sum Line leak detectors not installed or failed to detect a 3 -gallon Per hour leak at 10 psi Spill container failed to contain a minimum capacity of five gallons, or failed to provide a means (M2) to keepthe spill container em t ) Overfill prevention system was overridden or failed to meet overfill requirements in this section (M2) Failed to have secondary containment for pining includes conventional suction piping) Water in 20 containment not removed, analyzed & properly disposed of (M2) Unauthorized release that, (c) did not escape secondary containment and cleaned up within eight (M1) hours was not recorded; (e) escaped secondary containment, not cleaned up after eight hours, or a sudden loss of product was not re orted to the EHD within 24 hours Failed to inform the EHD of a chan a of des: gnated operator within 30 days!cejrtific�ation Designated operator did not ossess a current ICC UST System Operator Received by; r;«1e. EHD 23-02-002 REV 06/28/10 Page 1 1 1{ UST INSPECTION REPORT