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SAN JOAQUIN COUNTY <br /> l ONVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3"Floor, Stockton,CA 9520 -2708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sj og v.orp/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> rnw56A LIG?UQK ?SOU 614#Zfn/uK JWS•t VIVO(0 <br /> Facility address: UST# <br /> V90 N MAIN 97kes-T 3 4� s <br /> " Product <br /> Facility Contact: Title: Phone: <br /> GtukmAr� '36,6T SANDHI ( � Z3�i-43Sn <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> VP- S 3SV NOPressurized ❑Suction ❑Gravity f?'Mechanical ❑Audible/visual <br /> Inspection type: Violations: <br /> WRoutine EfMonitoring Certification ❑Installation ❑Other: [?MI-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section B <br /> V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit to operate <br /> 2 CCR 2637 Secondary containment test perfonned <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 responsibility and CFO letter <br /> 5 CCR 2632 c 2 D Monitoring&response plan is current and filed with the local agency <br /> 6 CCR 2712' i Monitoring&re onse plan is onsite <br /> 7 CCR 2712 6 Maintenance&monitoring records MI <br /> 8 CCR 2643 d Daily monitoring of suction piping(pre-January, 1, 1984 <br /> 9 HSC 25292.1 UST system isoperated 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 V/ <br /> 12 HSC 25291 b UST system monitorin equipment is operational erational M2 <br /> 13 CCR 2636 1 Continuous monitoring 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 pipingflow to a collection sum <br /> 17 HSC 25291 ( Line leak detectors are installed MI <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 Recording/reporting of unauthorized releases MI <br /> 23 CCR 2715 Desi nated Operator:(a)Statement from UST owner; (c-c)Monthly inspection; Employee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (MI) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636( (4) Annual line tightness test Ml <br /> 28 CCR 2661 (f) Repair for tank/pipingphas had tightness test M2 <br /> 29 CCR 2643 a Biennial ti ghtness test of gravity piping(pre-January 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping(pre-January1, 1984 (Mi) <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 34 FISC 25298 Permit to temporarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299 a 9 Disablin leak detection devices <br /> 37 HSC 25298 a) Ille al abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> Septic system: <br /> t ❑Serves>_20 people/day <br /> RECEIVED Y: TITLE: ❑Receives other than sanitary waste <br /> Other disposal methods- <br /> C.l d C Dry wells/French Drains <br /> EHD 23-02-002 <br />