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SAN JOAQUIN COUNTY <br /> ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> " .. 304 East Weber Avenue, 3d Floor, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> At�-.o �3�g DAw^> p�ttJs�tt.� 2-b-o1 <br /> Facility address: UST# <br /> Product b, .411.. <br /> Facility Contact: 1^Agft �,tylyy�o itle: Phone: <br /> d p�R` MANA4(.� Q brL-88 l S <br /> Monitoring Panels Pi ing system: Overfill prevention: / <br /> iulbAALD E(AC, Pressurized ❑Suction ❑Gravi ❑Mechanical udible/visual <br /> Inspection type: Violations: <br /> Routine Monitoring Certification ❑Installation ❑Other: ❑Ml-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATIONS) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR 2637 7—econdary containment test Performed <br /> 3 CCR 2711 )& c Current Unified Pro am Consolidated Forms on file with EHD(Facility and tank form <br /> 4 HSC 25292.2 Certification of financial reTonsibility and CFO letter <br /> 5 CCR 2632(c) 2 D Monitoring&res onse 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 (MI <br /> 8 CCR 2643 d Daily monitoring of suction piping(pre-januLry, 1, 1984 <br /> 9 HSC 25292.1 UST s stem is o erwcd to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present Ml <br /> 1 I CCR 2630(d) UST system monitoring equipment is properly located to detect a leak Mt) <br /> 12 HSC 25291 UST system monitoring equip mant isoperational M2 <br /> 13CCR 2636 0 1) Continuous monitoringsystem for under ound piping&UDC is resent MI) <br /> 14 CCR 2631 a Primar containment is roduct ti ht <br /> 15 HSC 25291 a)(2 Secondary containment for UST is ti ht <br /> 16 CCR 2636 c 1 All releases in second i j,g flow to a collection sum <br /> 17 HSC 25291 Line leak detector(s)are installed Ml) <br /> 18 CCR 2635 1 S ill container M2 <br /> 19 CCR 2635 2) Overfill revention s stem M2) <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 20 containment anal zed&------1 ;,--,-A of <br /> 22 CCR 2650 Recording/reportingof unauthorized releases Ml <br /> 23 CCR 2715 Desi ated n--tora)Statement from UST owner; c-e)Monthlyinspection; Employee training <br /> 24 CCR 2638 a Annual monitoringcertification <br /> 25 CCR 2638(a) Annual line leak detector test Ml <br /> 26 HSC 25284.2 Annuals ill containment testin <br /> 27 CCR 2636( 4) Annual line tightness test (Ml <br /> 28 CCR 2661 Re air for tank/pipinghas had tightness test M2 <br /> 29 CCR 2643 e) Biennial tightness test of gravitypiping( re-Janua 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction i in re-Janua 1, 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 <br /> 33 HSC 25286(a Permit to alter monitoring system <br /> 34 HSC 25298 b Permit to temnorarily close UST s stem <br /> 35 HSC 25298(c) Permit to close UST system <br /> 36 HSC 25299 a 9 Djsa lira leak detection devices <br /> 37 HSC 25298 a) Ill- al abandonment of UST s stem <br /> 38 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> /_G 7 t L(D 4� Septic system: <br /> lt L,L t76 7—l.l CJ ❑Serves 220 people/day <br /> RECEIVED BY: TITLE: ❑Receives other than sanitary waste <br /> Other disposal methods: <br /> ❑Dry wells/French Drains <br /> EHD 23-02 <br /> 1/3/07 <br />