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• SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, California 95202-3029 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT EHD 23-02-002 REV 05/07 L'A DesigppI d Operator: pe doy,pate: LF..'I'ttX a��dress:�},�-�//n W 'L�G l��'i'///��"' UST# "12, Fqpi&y Contact: Product �d p5L yJ Q4171- Title: Pho e- Ym - 13 ' P nc �) Pi ing sys[ m: j Overfill prevention: / t/ 1 spection type: Pressurized ❑ Suction ❑ GravityMechanical ❑ Audible/visual Routine )(MonitoringCertification ❑ Installation ❑ Other: vi lations: M I-RDetect ❑ M2-RPrev ❑ M-3 Both # Code Section VIOLATION(S) HSC=Califomia Health & Safety Code; CC =Califomia Code of Regulations V R I HSC 25284 V=Violation; RV=R eat Violation V Permit too este 2 CCR 2637 Secondary containment test performed 3 CCR 2711 b) & c Current Unified Pro ram Consolidated Forms on file with EHD (Facilityand 4 HSC 25292.2 Certification of financial res orisibility and CFO letter tank form 5 CCR 2632 6 Monitorin Pro ram(Monitoring & Res onse Plan) is current and a22noved by the local a enc 6 CCR 2712 i) Monitorin Ian is onsite. . 10-1 7 CCR 2712 b Maintenance & monitorin records 8 CCR 2643 d Dail monitorin of suction M 1 2iping (ore -January, I, 1984) 9 HSC 25292.1 UST s stem iso erated to 10 CCR 2632 c) 2) plcvunt unauthorized release UST monitorin s -em isresent I I CCR 2630 d UST s stem monitorin a ui ment is ro erl located to detect a leak Ml 12 HSC 25291 b UST s stem monitoring equipment iso erational M 1 13 CCR 2636 I M2) Continuous monitorin s stem for 14 under round i in & UDC is resent MI CCR 2631 a Prima containment is roduct ti ht 15 HSC 25291 a 2 Seconda containment for UST is ti ht 16 CCR 2636 'c 1) All releases in secondary pipingflow to a collection sum 17 HSC 25291 Line leak detecto s are installed 18 CCR 2635 b 1) S ill container M I 19 CCR 2635 b 2 Overfill revention system (M2) 20 CCR 2636 a () M2) Conventional suction piping shall have continuous monitoring & 20 containment 21 HSC 25291 e () Water in 2° containment analyzed &Eroeerly disposed of ✓ 22 CCR 2650 Recordin reportingo nauthorized releases 23 CCR 2715 Ml) Desi mated O erato a) ta—ment from UST owner c -e Monthl ins ection; t) Em to ee trainin 24 CCR 2638 a Annual monitorin c ication 25 CCR 2638 a) Annual line leak detector test 26 HSC 25284.2 Annuals ill containment testing Ml) 27 CCR 2636 4) Annual line tightness test 28 CCR 2661 t Repair for tank/ i2ing has had tightness test MI) 29 CCR 2643 a Biennial ti htness test ofgravity i in re-Janua I, 1984) (M2) 30 CCR 2643 d) Triennial line test for conventional suction piemE (pre -January I, 1984) 31 HSC 25292.5 Double walls stem located within 1000' o'public well-ELD MI) 32 CCR 2661 Permit to re air UST s stem 33 HSC 25286 a Permit to alter monitorin s stem 34 HSC 25298 b) Permit to tem oraril close UST s stem 35 HSC 25298 c Permit to close UST system 36 HSC 25299 (a) 9) Disablin leak detection devices 37 HSC 25298 a) Ille al abandonment of UST system 8 Other: t SP PHp UIC Serotic system- - Smes>_20 people/day ECE 'D BY: TI LE: - Receives other than sanitary waste Other disposal methods: - wells/French Drains EHD 23-02-002 REV 05/07 L'A