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# SAN JOAQUIN COUNTY <br /> WNVIRONMENTAL HEALTH DEPARTMEN* <br /> 304 East Weber Avenue, 3`"Floor, Stockton,CA 95202-2708 <br /> Telephone: (209)468-3420 Far:(209)468-3433 Web:www.sj og v or <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> UAs P090T I N . Klee 3�0�/ab <br /> Facility address: �/ t/ UST# <br /> pi.f Cr e's6 17F uE Product S 1 & 1 ) <br /> Facility Contact: Title: Phone: <br /> Monitoring Panel: Piping system: _Overfill prevention: <br /> vie TLS Vs ressurized D Suction D Gravity6Aechanical D Audible/visual <br /> Inspection type: M��// Violations: <br /> @Routine VMCertification D Installation D Other: ❑Ml-RDetect D M2-RP"' D M-3 Both <br /> # Code Section <br /> VIOLATIONS) HSC=Califomia Health&Safety Code;CCR=California Code of Regulations V R V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 b & c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br /> 4 HSC 25292.2. Certification of financial res onsib lity and CFO letter <br /> 5 CCR 2632 c 2 D Monitoring&response plan is current and filed with the local agency <br /> 6 1 CCR 2712 p)'... Monitoring&response plan is onsite <br /> 7 CCR 2712 b Maintenance&monitoring records Ml <br /> '.8 ICCR 2643 d Daily monitoring of suction piping(preoJanuary, 1, 1984) <br /> 9 HSC 25292.1 UST system is operated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present MI <br /> 11 CCR 2630(d) UST system monitoring equipment is properly located to detect a leak Ml <br /> 12 HSC 25291 UST system monitoring equipment is o p erational M2 <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping&UDC is present Ml <br /> 14. CCR 2631 a Primary y 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 pipingflow to a collection sum <br /> 17 HSC 25291 Line leak detectors are installed M1 <br /> 18 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&20 containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Recordin reportingg of unauthorized releases MI <br /> 23 CCR 2715 Designated Operator: a Statement from UST owner; (c-c)Monthly inspection;(f)Employee training ✓ <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638 a Annual line leak detector test (M] <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test Ml <br /> 28 : CCR 2661 Repair for tank/piping has had tightness test M2 <br /> 29 CCR 2643 a Biennial tightness test of gravity pipingre-Janus 1, 1984 <br /> 30 CCR 2643 d Triennial linetest for conventional suction p piping p re-Jana 1, 1984 (MI) <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit toreair UST system <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 34 HSC.25298 ) Permit to temporarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299(a)(9) Disabling leak detection devices <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other: . <br /> EHD INSPECTOR: PHONE: UIC <br /> ').oaf 4.68 -3�-301 Septic system: <br /> =Serves>_20 people/day <br /> RECEIVED B TITLE: C Receives other than sanitary waste <br /> �- _ Other disposal methods: <br /> -- _ 2T�° C Dry wells/French Drains <br /> F.HD 23-02-002 <br />