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SAN JOAQUIN COUNTY 46 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax: (209)468-3433 Web:www.sjgov.org/ <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT Of Inspection Dale: <br /> Des' o <br /> Facility name: <br /> UST# <br /> Facility <br /> /address: ` /1�,v� <br /> Product t•I "s"1 <br /> Phone: <br /> Facility Contac[: Title: <br /> LemMe✓lJ�k s <br /> Overfill prevention: <br /> Monitoring Panel: Piping system: <br /> Mechanical 11Audiblelvisual <br /> Pressurized Suction ❑Gravit Violations: <br /> 1 pection type: ,,( [I MI-RDetect ❑M2-RPrev [IM-3 Both <br /> Routine ¢(Monitorin Certification ❑Installation ❑Other: V R <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V <br /> # Code Section V=Violation;RV=Repeat Violation <br /> 1 HSC 25284 Permit too emte <br /> 2 CCR 2637 Secondary containment test Performed <br /> 3 CCR 2711 b)& c Current Unified program Consolidated Forms on file with EHD Facili and tank form <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 b Monitoring Program Monitorin &Response Plan)is current and approved by the local a enc . <br /> 6 CCR2712 f Monitorin lanisonsite. Ml <br /> 7 CCR 2712 b Maintenance&monitoring records <br /> 8 CCR 2643 d Dail monitorin of suction i in unauthorized <br /> , el ase <br /> 9 HSC 25292.1 UST s stem isoperated to revent unauthorized release (M 1) <br /> 10 CCR 2632 c) 2) UST monitoring s stem is present MI <br /> I I CCR 2630 d UST s stem monitorin a ui ment is property located to detect a leak M2) <br /> 12 HSC 25291 b) UST s stem monitoring equipment iso erational Ml <br /> 13 CCR 2636 l Continuous monitoring system for under round ppng&UDC is resent <br /> 14 CCR 2631 a Prima containment is roduct ti ht <br /> I S HSC 25291 a 2 Seconda containment for UST is ti ht <br /> r. 16 CCR 2636 c l) All releases in Seconda i in flow to a collection sum Ml <br /> 17 HSC 25291 t Line leak detectors are installed (M2) <br /> 18 CCR 2635 b) 1) S ill container (M2) <br /> 19 CCR 2635 b 2 Overfill revention s stem <br /> 20 CCR 2636(a) Conventional suctionpiping shall have continuous monitoring&20 containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed& to erly dis osed of (M 1) <br /> 22 CCR 2650 Recordin re ortin of unauthorized releases <br /> 23 CCR 2715 Desi oared erator. Statement tirom UST owner; c onthl ins ection; t)Em to ee tramin <br /> 24 CCR 2638 a Annual monitorin certification (Ml) <br /> 25 CCR 2638 a) Annual line leak detector test <br /> 26 HSC 25284.2 Annuals ill containment testin MI) <br /> 27 CCR 2636 t 4) Annual line ti htness test (M2) <br /> 28 CCR 2661 t Repair for tank/piping has had ti loess test <br /> 29 CCR 2643 a Biennial tightness test of gravity pi in rt lama I, 1984 MI) <br /> 30 CCR 2643 d) Triennial line test for conventional suction i in ( re-Janus I, 1984) <br /> 31 HSC 25292.5 Double wall s stem located within 1000' --public well-ELD <br /> 32 CCR 2661 Permit to r air UST s stem <br /> 33 HSC 25286 a Permit to alter monitorin —t- <br /> 34 <br /> 34 HSC 25298 b) Permit to tem omril close UST system <br /> 35 HSC 25298 c) Permit to close UST s stem <br /> 36 HSC 25299 a) 9) Disablin leak detection devices <br /> 37 HSC 25298 a) the at abandonment of UST system <br /> 38 Other. UIC <br /> PHONE: <br /> EHD INSP O _ Et <br /> p- Septic system: <br /> q Serves 220 people/day, <br /> TITLE• -Receives other than sanitary waste <br /> RECEIVED BY: � ,,, Other disposal methods <br /> Dry wells/French Drains <br /> EHD 23-02-002 REV 05/07 <br />