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* SAN JOAQUIN COUNTY <br /> VIRONMENTAL HEALTH DEPARTMENT <br /> 304 Eas Weber Avenue,3`"Floor, Stockton,CA 95202- /08 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.orPJehd <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> SO(AV LAIJi) l— E LPi/61 ! l� Vtt crarcl^eod I/Za/v6 <br /> Facility address: UST# <br /> 4�11F3 S Hw`1 `Iq .. I $7 <br /> Facility Contact: Title: Product <br /> Phone: <br /> TtVTLOAE{ GILL 001051! (209) 939-6679 <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> TLS S Pressurized ❑Suction ❑Gravity &Mechanical ❑Audible/visual <br /> Inspection type: <br /> Violations: <br /> SKoutine "onitoring Certification D Installation D Other: D MI-RDetect D M2-RPrev D M-3 Both <br /> # Code Section VIOLATION(S) HSC=California Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> 1 HSC 25284 Permit too este V=Violation;RV=Re eat Violation V <br /> 2 CCR 2637 Second containment---[ erfomted <br /> 3 CCR 2711 b & c Current Unified Pro am Consolidated Forms on file with EHD(Facility and tank form <br /> 4 HSC 25292.2 Certification offinancial res onsibili and CFO letter <br /> 5 CCR 2632 c 2 D Monitorin &res Dose Ian is current and filed with the local a enc <br /> 6 CCR 2712 i Monitorin &res onse pplan is onsite <br /> 7 CCR 2712 b Maintenance&monitorin records MI <br /> 8 CCR 2643(d Dail monitoringof suction i in (pre-January, 1, 1984 <br /> 9 HSC 25292.1 UST s stem iso -rated to revent unauthorized release <br /> 10 : CCR 2632(c)(2 UST monitoring s tem is resent:.. Ml <br /> 1 I CCR 2630 d UST s stem monitorin a ui men-is ro erl located to detect a leak MI <br /> 12 HSC 25291 FUST s stem monitor n e ui nt is o -rational M2 <br /> 13 CCR 2636 1 '--ing 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 piping:flow to acollection sum <br /> 17 HSC 25291 Line leak detectors are installed Ml <br /> I8 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&2'containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 l ecordin re ortin 'of unauthorized releases Ml <br /> 23 CCR 2715 Desi nated erator: (a)Statement from UST owner; (c-e)Monthly in ection; f)Em to ee trainin <br /> 24 : CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (Ml <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test MI <br /> 128 CCR 2661 (f) Repair for tank/ i in g has had tightness test M2 <br /> 29 CCR 2643 a Biennial ti hmess test of gravity pipingre-Jana 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional:suction i in g e-Janu 1, 1984 Ml <br /> -31 HSC 25292.5 Double walls stem located within 1000'of ublic well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286 a Petmit to alter monitoring system <br /> 34 HSC: 55298 Permit to temporarily close UST s stem <br /> 35 HSC 25298 c Permit to close UST system <br /> sab <br /> 36 HSC 25299 a 9 Dili; 'leak detections devices <br /> 37 HSC 25298 a legal abandonment o UST system <br /> 38 Other: <br /> EHD INSPECTOR: P 'E: UIC <br /> (��j, g _�w3 Septic system <br /> RECEIVED BY: es>-20 people/day <br /> TITLE;� <br /> 0 Receives other than sanitary waste <br /> Other disposal methods <br /> Dry wells/French Drains <br /> END 23-02-002 <br />