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SAN JOAQUIN COUNTV
<br />"NVIRONMENTALHEALTH,DEPARTMENT -
<br />304 East Weber Avenue, 3r° Floor; Stockton. C.A. 95202-2708
<br />Telephone: (209) 4683420 Fax: (209) 468-3433 Web: www.sj ov.or ehd
<br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT
<br />Facility ...
<br />Designated Operator:
<br />inepeition Date:
<br />/•name;
<br />Ficility address:
<br />-
<br />USTN
<br />/
<br />F
<br />qq I
<br />'Product
<br />�7
<br />Facility Contact:
<br />_ Title: Phoney
<br />;�.,) ?l IZ
<br />Al Crkl G yr 0P,:'N/1,',(! ( U:I) 5`1`/' 2i!
<br />Monitoring Panel:
<br />Piping system; -
<br />.Overfill prevention:
<br />,! ? , C I � %i S
<br />04.ssurized 0 Suction 0 Gr&vl
<br />�,`
<br />31Mechanical Audiblelvisual
<br />Inspection type:
<br />Violations:
<br />9.Routine IidMwitming Certification 0 Installation 0 Other:
<br />0 M I-RDetect 0 M2-RPrev 0 M-3 Both
<br />VIOLATION(S) HSC=Califomis Health & Safety Code; CCR=California Code of Regulations V R
<br /># Code Section
<br />- y
<br />V=violation• RV=Repeat Violation
<br />I HSC 25284
<br />Permit tooperate
<br />3 CCR b & c
<br />Current Unified Pro ramlConsolidated Fonns on file with EHD (Facility and tank form)-
<br />NN2dd711�x
<br />� �' �. erEtiSM1tAAM:a5AH1L'NI ... r.... il4ri prt � "rt"J leiter .., 4 .r�
<br />5 CCR 2632 c 2 D
<br />Monito7rin &res onse, lar is current and fled with the local agency
<br />f'' 1' r • ..:�1 n' {t f{dtni 1�Ct1"k9...tilMl'S' b [e i•! s r1 '. '.:.!i
<br />7 CCR 2712 bj
<br />Maintenance & monitoring records 1
<br />X ["i i�. '"iN u
<br />9 HSC 25292.1
<br />USTs em iso operated to revent unauthorized release
<br />x� Y 1IOF'� b 8
<br />11 CCR 2630 d
<br />UST system monitorinequip mentis ro erl located [o detect a leak 1
<br />;32 kJ6 ;2 9 c .
<br />t A 1 .:._ fid .,. � ntigo tmal tlli'16 :.
<br />'
<br />13. CCR 2636 ]
<br />undererod i 'n &UDC is esent :�fl
<br />Continuous monitorin s stem for un
<br />ryry aa�� �y�yyryryyypQpal Pppp N�N�u�u¢
<br />•yi •::: R1F'iF3r 'n ni.Il''`::iioam ffir�¢;atl 1N61 F1LSL•ii •. L. I• .r �'::• '' I'4fi1 f'
<br />HSC 25291 a 2
<br />Secondary containment for UST is ti t
<br />q15
<br />PONI"
<br />17 HSC 25291
<br />Line leak detector s are installed 1
<br />I :
<br />,Overffi1reven
<br />19 CCR 2635 (b)(2)
<br />tioos temrr _,_._:��
<br />-._
<br />�f[I.tr9110{i'bMi�i.,..., .. .r 1: � ,1XIlti'Ij....: .�•, ...,
<br />HSC 25291 (e)
<br />Water in 20 containment analyzed & erl chso£
<br />iI21 Fed
<br />I
<br />n, n,.n n n ,::r , !dL , Ilrr• , 4 • ,
<br />23 CCR 2715
<br />ated erator. a Statement from UST owner; c -e Monthl ins ction; Em to ee tramin v'
<br />Desi ( )
<br />' � ..'aria 1 i.., •t�lartQnttQ ......r ..'I!Il if III' •::ii . I r:ill:l. I ..Y. �..: I 4. °P'ir IYI:' I.:Y..
<br />25 CCR 2638 a
<br />Annual line leak detector test M1
<br />Y�1y1eaµrWNx ,yh@y ��{{ µ .:.,. i, ....... I I 1 I'I.i 3 I ::• � LL ��", :p M I 11 91r1i'} IIIV ` . I I:.,:
<br />riPIA:MY.!�.WW��'Tt!♦Pkl: null ..:. `.-, ., r ...r .....r r,ll.:�.l...:. '. kP �.:.: ,.:, ,
<br />27 CCR Z63(i 4
<br />Annual line tightness test - Ml
<br />I'" ?� ,.':' i
<br />plfdy'IxtrWJ!'rr ..� r ay �r r� .. �•t ;1111 i1u'.....r .1 I � :.. U'Mv LY 1: �:'I 7777
<br />a n
<br />29 1 CCR 2643 a
<br />Biennial it fitness test of gravit i in re -Jana 1 ]984
<br />mi H.Nvi,
<br />31 HSC 25292.5
<br />Double wall stem (scaled wtthtn 1000 of ubhc well ELD
<br />31
<br />•;, r1 ':: 1 r: ly
<br />II aI1.
<br />33 HSC 25286 a
<br />Pcmtrt to alter monitoring oun system
<br />L. ,0 ��� .
<br />d t1,9
<br />..... ..
<br />"r1 1 an b
<br />i-. .-
<br />n I
<br />35 HSC 25298 c
<br />Permit to close UST system
<br />79, flI rr:.,
<br />p
<br />16 �i4 4r, r, Ntitwfl i -
<br />37 HSC 25298 a
<br />I3tS
<br />Ille al abandonmtait of UST s stem
<br />111
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<br />PHONE: "" -
<br />is .UA r1 is 1i
<br />EHD INSPECTOR:
<br />UIC
<br />51ndc systcm:
<br />0 Serves 220 pcoplc/day
<br />❑ Receives other than sanitary waste
<br />RECE)IV It BY:r
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<br />TI E:
<br />.- ,' x£"f: .'^""'•'^^^°"'"r"�''
<br />j
<br />A 4;
<br />Other dismsal methods:
<br />n Drywcl15/Trench Drains
<br />EHD 23-02-002
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