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1\ <br />F"HD 23-02-002 <br />Dry wellslFrench Drains <br />SAN JOAQUIN COUNTY <br />WIRONMENTAL HEALTH DEPARTMENT4 <br />304 East Weber Avenue, 3r° Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.or%z/eh <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility name: <br />Designated Operator: <br />Inspection Date: <br />w(we CVUw1P-4 <br />a�J :517m D <br />18(os_ <br />Facility address: <br />LIST # <br />7773 <br />ilit kL�MJ <br />Lra�G <br />- Product <br />g� <br />ql <br />Facility Contact: <br />Title: Phone: ' <br />Wo<rl <br />36`�- <br />Monitoring Panel: <br />Piping system: Overfill prevention: <br />G1 LC- <br />wce M (r <br />Vk Iessurized ❑ Suction ❑ Grainy C1Kechanical ❑ Audible/visual <br />Inspection type: Violations: <br />�IRoutine onitoring Certification C Installation ❑ Other: ❑ M I-RDetect ❑ M2-RPrev <br />❑ M-3 Both <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=California Code of Regulations <br />V R <br /># Code Section <br />V=Violation; RV=Re eat Violation <br />V <br />1 HSC 25284 <br />Permit tooperate <br />2 CCR 2637 <br />Second containment test performed <br />3 CCR 2711 b) & c) <br />Current Unified Pro ram Consolidated Forms on file with EHD (Facility and tank form) <br />4 HSC 25292.2 <br />Certification of financial responsibility and CFO letter <br />5 CCR 2632 (c)(2)(D) <br />Monitoring & response plan is current and filed with the local agency <br />6 CCR 2712 i <br />Monitoring & response plan is onsite <br />7 CCR 2712 b) <br />i Maintenance & monitoring records <br />M1 <br />8 CCR 2643 d) <br />Daily monitoring of suctiont in (pre -January, 1, 1984) <br />9 HSC 25292.1 <br />UST system isoperated to prevent unauthorized release <br />10 CCR 2632 (c)(2) <br />UST monitoring system is present <br />(Mi) <br />11 CCR 2630 (d) <br />UST system monitoring equipment is properly located to detect a leak <br />M1 <br />12 HSC 2.3291 b <br />UST system monitoring equipment isoperational <br />M2 <br />13 CCR 2636 (f)(1) <br />Continuous monitoring system for underground piping & UDC is present <br />(M1 <br />14 CCR 2631 a) <br />Primary containment is product tight <br />15 HSC 25291 (a)(2) <br />Secondary containment for UST is tight <br />16 CCR 2636 (c)(1) <br />All releases in secondary pipingflaw to a collection sum <br />17 HSC 25291 (f) <br />Line leak detector(s) are installed <br />(M1 <br />18 CCR 2635 (b)(1) <br />Spill container <br />M2 <br />19 CCR 2635 (b)(2) <br />Overfill prevention system <br />M2 <br />20 CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 2° containment <br />21 HSC 25291 (e) <br />Water in 2° containment analyzed & properly disposed of <br />22 CCR 2650 <br />Recording/reporting of unauthorized releases <br />M1 <br />23 CCR 2715 <br />Designated O erator: (a) Statement from UST owner; (c -e) Monthly inspection; (f) Employee training <br />24 CCR 2638 a <br />Annual monitoring certification <br />25 CCR 2638 (a) <br />Annual line leak detector test <br />(MI) <br />26 HSC 25284.2 <br />Annual spill containment testing <br />27 CCR 2636 (f)(4) <br />Annual line tightness test <br />M1 <br />28 CCR 2661 ( <br />Repair for tank/piping has had tightness test <br />M2 <br />29 CCR 2643 (e) <br />Biennial tightness test ofgravity piping ( e -January 1, 1984) <br />30 CCR 2643 (d) <br />Triennial line test for conventional suction piping (pre -January 1, 1984) <br />(M1 <br />31 NSC 25292.5 <br />Double walls stem located within 1000' of Public well-ELD <br />32 CCR 2661 <br />Permit to repair UST system <br />33 HSC 25286 a <br />Permit to alter monitoring system <br />34 HSC 25298 (b) <br />Permit to temporarily close UST system <br />35 HSC 25298 (c) <br />Permit to close UST system <br />•36 HSC 25291(a) 9 <br />Disabling leak detection devices <br />37 HSC 25298 a) <br />Ille a1 abandonment of UST system <br />38 Other: <br />EHD I SSPECTOR: <br />PHO E: <br />4 6 3 3,Gt Septic system: <br />UIC <br />• IV At� }�'� <br />l J Serves >_20 people/day <br />RECEIVED BY: <br />TITLE: � Receives other than sanitary waste <br />A Other disposal methods: <br />1\ <br />F"HD 23-02-002 <br />Dry wellslFrench Drains <br />