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S%e SAN JOAQUIN COUNTY ""f <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street,Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sigov.orp-/ehd <br /> UNDERGROUND STORAGE TANK{(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Design ted Operator: les n Date: <br /> Lyfj <br /> s !Aj <br /> �,�� <br /> Facility address: UST# <br /> GilCom 6N✓� <br /> "Product �- <br /> Facility Contact: Title: L Phone: <br /> nitoring Panel: Piping system: Overfill prevention: <br /> _t essurized ❑Suction ❑Gravity 0 hanical EJ Audible/visual <br /> Inspection type: Violations <br /> Routine Monitorin Certification ❑Installation ❑Other: ❑M I-RDetect ❑M2-RPrev 1.1-3 Both <br /> VIOLATIONS HSC=California Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section � � Y g <br /> V=Violation;RV=Repeat Violation V <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 b Monitoring Program Monitorin&&Response Plan)is current and approved by the local agency. <br /> 6 CCR 2712 i Monitoring Ian is onsite. <br /> 7 CCR 2712 b) Maintenance&monitoring records M 1) <br /> 8 CCR 2643 d) Daily monitoring of suction piping(prc-January, 1, 1984) <br /> 9 HSC 25292.1 UST system is operated to prevent unauthorized release <br /> 10 CCR 2632 c)(2) UST monitoring system is Eresent M1) <br /> I 1 CCR 2630 d) UST system monitoring equipment is properl located to detect a leak (M 1) <br /> 12 HSC 25291 b) UST system monitoring equipment isoperational (Nl2) <br /> 13 CCR 2636(f(I) Continuous monitoring system for underground piping&UDC is present M1 <br /> 14 CCR 2631 a) Primary containment is eroduct 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 t Line leak detector(s)are installed <br /> 19 CCR 2635(b)(1) 5 ill container (!BIZ) <br /> 19 CCR 2635(b)(2) Overfill prevention system (M2) <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2°containment <br /> 21 1 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/LTorting of unauthorized releases (YI l) <br /> 23 CCR 2715 Designated O erator:(a)Statement from UST owner; (c-e)Month!y inspection, t) 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 Annual spill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test M1) <br /> 28 CCR 2661 f Re air for tank/piping has had tightness test M2) <br /> 29 CCR 2643 a Biennial tightness test of ravitt in re-Jams I, 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 Pen-nit to repair UST system <br /> 33 1 HSC 25286 a Permit to alter monitoring system <br /> 34 1 HSC 2529$ b) Permit to temporarily close UST system <br /> 35 HSC 25298 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: i PHONE: UIC <br /> f! (/p Se tie -tem: <br /> Sery �0 people/day <br /> RECE ED TITLE: Receives than sanitary waste <br /> Other disposal ineth <br /> �p� — wells/French s <br /> EHD 23-02-002 REV 05/07 <br />