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0 SAN JOAQUIN COUNTY fo <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.orWehd <br />U IN UEKkyKV U 1V I) J C V KAkxL 1 AIN K (USI) t -KV kxKA1V1 11V S rEq— 11 V 1V KLr P V K 1 <br />Facility name:esi <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 20 containment <br />Dated O erator: <br />Eta aoCs <br />21 <br />Inspection Date: <br />Water in 20 containment analyzed & Properly disposed of <br />22 <br />kw(, awe <br />Rmordin orcin ' nauthorized releases i- <br />6 <br />Facility' addres(s:/� <br />4 q, <br />U <br />Designated crato : ( <br />UST # <br />(y,► <br />n/, <br />r.(,� <br />l ✓ <br />W t <br />Product <br />CCR 2638 a) <br />'Annual line leak detector test <br />(Ml) <br />Fa 'lity Contac• <br />Tide: <br />'^� <br />Phone: <br />27 <br />CCR 2636 4) <br />Annual line tightness test <br />VY <br />28 <br />CCR 2661 <br />Repair for tank/piping has had tightness test <br />(M2) <br />29 <br />CCR 2643 a <br />nit�n¢,P9y�1• .� <br />%iki <br />,tPPiiping system: <br />AO/Pressurized ❑ Suction <br />❑ Gravity <br />Overfill prevention: <br />11 Mechanical tKudible/visual <br />r <br />Code Section VIOLATION(S) HSC=Califomia Health & Safety Code; CCR=California Code of Regulations V R <br /># <br />V=Violation: RV=Repeat Violation V <br />s.t.rc e t t t of ac c wrrem unrtea rro am s,onsouaateu ronns on me wtrn cn� racut ana an, rorm) <br />4 HSC 25292.2 Certification of financial responsibility and CFO letter <br />1 16 1 CCR 2636 (c)(1) I All releases in secondary pining flow to a collection sump I I <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 20 containment <br />21 <br />HSC 25291 (e) <br />Water in 20 containment analyzed & Properly disposed of <br />22 <br />CCR 2650 <br />Rmordin orcin ' nauthorized releases i- <br />Ml <br />23 <br />CCR 2715 <br />Designated crato : ( <br />Statement from UST owner, (c -c Monthly inspection fl m to ee trainin71, <br />24 <br />CCR 2638 a <br />Annual monitoring c rtification <br />25 <br />CCR 2638 a) <br />'Annual line leak detector test <br />(Ml) <br />26 <br />HSC 25284.2 <br />Annuals ill containment testing <br />27 <br />CCR 2636 4) <br />Annual line tightness test <br />M1) <br />28 <br />CCR 2661 <br />Repair for tank/piping has had tightness test <br />(M2) <br />29 <br />CCR 2643 a <br />Biennial ti htness test of gravity piping (pre-JanuaryI, 1984 <br />30 <br />CCR 2643(d) <br />Triennial line test for conventional suction piping (pre -January I, 1984) <br />MI) <br />31 <br />HSC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <br />32 <br />CCR 2661 <br />Permit to repair UST system <br />33 <br />HSC 25286 a <br />Permit to alter monitoring system <br />34 <br />HSC 25298 (b) <br />Permit to temporarily close UST system <br />TITLE: <br />EHD 23-02-002 REV 05/07 <br />Septic system: <br />Serves 220 people/day <br />Receives other than sanitary waste <br />Other disposal methods: <br />- Dry wells/French Drains <br />