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0 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sieov.ore/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> �� L11/t� Vit.�.P.t'� e 4--3G2 S ) . <br /> Facility address: <br /> UST# , /L (� , <br /> V 1� + 'Product -I 7, <br /> Facilit Contact: � Title: Phone: <br /> � " <br /> o 'oring Panel: Piping system: Overfill prevention: <br /> IJL& I ressurized ❑Suction ❑Gravityechanical 11Audible/visual <br /> Inspection type: iolations: <br /> Routine 19fionitoring Certification ❑Installation ❑Other: I-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=California Code of Regulations V R <br /> V <br /> V=Violation; RV=Repeat Violation <br /> I HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary 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 6 Monitoring Program(Monitoring&Response Plan is current and approved by the local agency. <br /> 6 CCR 2712 i) Monitoring Ian is onsite. <br /> 7 CCR 2712 6 Maintenance&monitoring records Ml <br /> 8 CCR 2643 d Daily monitoring of suction piping(pre-January, I, 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 /> I 1 CCR 2630 d UST system monitoring equipment is properl located to detect a leak M t) <br /> 12 HSC 25291 6 UST system monitoring equipment isoperational (M2 <br /> 13 CCR 2636 I 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 pipingflow to a collection sum <br /> 17 HSC 25291 Line leak detector(s) are installed Ml <br /> 18 CCR 2635(b)(1) Spill container (M2) <br /> 19 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 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases (MI) <br /> 23 CCR 2715 Designated Operator: (a)Statement from UST own c-e Monthly inspection; t1 Employee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638 a) Annual line leak detector test (M I) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4) Annual line tightness test M1) <br /> 28 CCR 2661 Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643 a Biennial tightness test of gravity piping(pre-January 1, 1984 <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping(pre-January 1, 1984) M1) <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 temporarily close UST system <br /> 35 HSC 25298 c) Permit to close UST system <br /> 36 HSC 25299 aisa ing leak detection devices <br /> 37 HSC 25298 a Illegal abandonment of UST s stem <br /> 31 Other: Ali C" <br /> E DNS C PHONE: �� UIC <br /> Sematic sys[em: <br /> Serves 10 people/day <br /> R CEIVED BY: t TITLE: -Receives other than sanitary waste <br /> \ Other dis'oosal methods: <br /> wells/French Drains <br /> EHD 23-02-002 REV 05/07 <br />