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• 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.sigov.org/ehd/unitiii.html <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Fesignated <br />$I�DE6 OcC 4l %u�L� acility name: <br />DOperator: Exp. date: <br />Inspection <br />Date: <br />3�23It0 <br />Facility address: /}�,-�,,, �� �p�� <br />2�S W tout - av""""-c— /�Gt'✓li—""' <br />UST{ <br />Product <br />(000 "' <br />6� -� <br />U <br />JV -' <br />Facility contact: ��_ �/ Title: <br />� ., Phone: <br />A V) �A.Z4" 6WAAW <br />ZSR <br />" <br />l <br />%moi <br />Monitoring panel: Piping system: <br />❑ Pressurized ❑ Suction ❑ Gravity <br />Overfill prevention: <br />❑ Mechanical ❑ Audible/visual <br />Inspection type: <br />Routine ❑ Monitoring Certification ❑ Installation ❑ Other: <br />Violations: <br />❑ M1-RDetect ❑ M2-RPrev ❑ M-3 Both <br />On site Technician's Name: <br />ICC Service Technician Exp. Date: <br />Manufacturer's Training: <br /># <br />Code Section <br />VIOLATION(S) HSC=Califomia Health & Safety Code; CCR=Califomia Code of Regulations <br />V=Violation; RV=Re eat Violation <br />V <br />R <br />V <br />1 <br />HSC 25284 <br />No permit to operate <br />2 <br />CCR 2637 <br />Secondary containment: (a) test not performed; (e) test report not submitted within 30 days; (1) test notification not <br />provided to the EHD at least 48 hours prior to conducting the test <br />3 <br />CCR 2711(b) & (c) <br />Current Unified Program Consolidated Forms not on file with the EHD (Facility and tank form) <br />4 <br />HSC 25292.2 <br />Current financial responsibility documents not on file with the EHD <br />5 <br />CCR 2632(b) <br />Monitoring Program (Monitoring & Response Plan) is not current or approved by the local agency <br />6 <br />CCR 2712(i) <br />Monitoring and/or response plan is not onsite <br />7 <br />CCR 2712(b) <br />Maintenance & monitoring records not maintained 3 years, cathodic protection records for 6 % years, (M7) <br />written performance claims pertaining to release detection systems for 5 years, or records of repairs, linings, and <br />upgrades for the life of the tank. Monitoring records include: (1) date and time of all monitoring or sampling; (2) <br />monitoring equipment calibration and maintenance records; (3) results of any visual observations; (4) results of <br />sample analysis performed a lab or in the field; (5) logs of all readings of gauges or other monitoring equipment, <br />ground water elevations, or other test results; 6 results of inventoryreadings and reconciliations. <br />8 <br />CCR 2643(d) <br />Daily monitoring of suction piping (pre -January 1, 1984) not performed <br />9 <br />HSC 25292.1 <br />UST system is not operated to prevent unauthorized release, including spills and overfills <br />0 <br />CCR 2632(c)(2) <br />Monitoring system is not present in the interstitial space of a double walled UST/piping (M1) <br />11 <br />CCR 2630(d) <br />UST monitoring equipment is not installed or maintained to detect a leak at the earliest opportunity (M1) <br />12 <br />HSC 25291(b) <br />UST system monitoring equipment is not operational (M1) <br />13 <br />CCR 2636(f)(1) <br />Failed to maintain a continuous monitoring system for underground piping & UDC that to activates an (M1) <br />audible and visual alarm or stops flow of product at the dispenser when it detects a leak <br />14 <br />CCR 2631(a) <br />Primary containment is not product tight <br />15 <br />HSC 25291(a)(2) <br />Secondary containment for UST system is not tight <br />16 <br />CCR 2636(c)(1) <br />All releases in secondary piping do not flow to a collection sump <br />17 <br />HSC 25291(f) <br />Line leak detector(s) not installed (M1) <br />18 <br />CCR 2635(b)(1) <br />Spill container not installed, failed to contain a minimum capacity of five gallons, or failed to provide (11,12) <br />a means to keep the spill container empty <br />19 <br />CCR 2635(b)(2) <br />Overfill prevention system was overridden or failed to meet overfill requirements in this section (M2) <br />20 <br />CCR 2636(a) <br />Failed to have secondary containment or continuous monitoring (includes conventional suction piping) <br />21 <br />HSC 25291(a) <br />Water in 21 containment not removed, analyzed & properly disposed of <br />22 <br />CCR 2650 <br />Unauthorized release that: (c) did not escape secondary containment and cleaned up within eight hours (Mt) <br />was not recorded; (e) escaped secondary containment, not cleaned up after eight hours, or a sudden loss of <br />product was not reported to the EHD within 24 hours <br />23a <br />CCR 2715(@) <br />Failed to inform the EHD of a change of designated operator within 30 days <br />23b <br />CCR 2715(b) <br />Designated operator did not possess a current ICC UST System Operator certification <br />23c <br />CCR 2715(c), (d), (e) <br />Designated operator monthly inspection: (c)(1) alarms not documented; (c)(2-4) spill containers, UDCs, and <br />sumps (if necessary) not inspected; (c)(5) required test dates not checked or noted; (c)(6) employee training not <br />verified; (d)(e) monthly inspection reports not maintained on site for at least 12 months <br />23d <br />CCR 2715(f) <br />Designated operator employee training: (1) not performed; (2) not current for at least one employee on site; (3) <br />o not kept <br />EHD INSPECTOR:: ,� /p <br />TITLE: <br />EHD 23-02-002 REV 12/09 Page 1 UST INSPECTION REPORT <br />