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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3rd Floor, Stockton,CA 95202- 708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www sieov org ehd <br /> Facility name: UNDERGROUND STORAGE TANK(UST PROGRAM INSPECTION REPORT <br /> Designated Operator:h� i Inspectio Date: <br /> �2Y✓ ZSlap <br /> Facility ad rens: 1*10 5 -T <br /> I o <br /> MarcLa USTa tP /� I <br /> Phone: <br /> Facility Contact: Title: Product / , .DO,* <br /> , <br /> MonitoringPangJ: Piping system: <br /> �S Pressurized ❑Suction Overfill prevention: <br /> Inspection type: D Oravit Mechanical <br /> Audible/visual <br /> Routine Monitorin Certificationsolations: <br /> 13 Installation ❑Other: MI-RDetect <br /> ❑M2-RPrev ❑M-3 Both <br /> # Code Section VIOLATIONS)HSC=Califomia Health&Safety Code;CCR=California Code of Regulations V R <br /> I HSC 25284Permit too erate V=Violation;RV=Re eat Violation V <br /> 2 'CCR 2637 Second containment test erformed <br /> 3 CCR 271 I b & c Current Unified Pro am Consolidated Forms on file with EHD Facilit and tank form <br /> 4 HSC 25292.2 Certificationof financial restionsibillLy and CFO letter <br /> 5 CCR 2632 c 2 D Monitorin &res onse Ian is current and filed with[he local a enc <br /> 6 CCR 2712 .i Monitorin &re use Ian is onsite <br /> 7 CCR 2712 b Maintenacoring records <br /> 8 CCR 2643 d Dail monitorin ofsuction Pipiu 17e-January, I, 1984 MI <br /> 9 HSC 25292.1 UST s stem isoperated to Prevent unauthorized release <br /> -10 CCR 2632 c 2 UST monitorin s stem is resent <br /> 1 I CCR 2630 d UST s stem monitoring equipment is rinnnerly located to detect a leak (Ml <br /> 12 HSC 25291 UST s tem monitorin a ui ment is o erational MI <br /> 13 CCR 2636 I Continuous monitoring system for underground piping&UDC is resent M2 <br /> 14 CCR 2631' a Prima r contammem is. roduct ti ht MI <br /> 15 HSC 25291 a 2 Seconda containment for UST is ti ht <br /> 16 CCR2636 c 1 All releases in secondn piping flow to a collection su <br /> 17 HSC 25291 Line leak detectors are installed <br /> 18 CCR 2635(b) 1) S ill container MI <br /> 19 CCR 2635 b 2 Overfill revention s stem M2 <br /> 20 CCR 2636(a) Conventional suction i in shall have continuous monitoring&2°containment <br /> M2 <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly dis osed of <br /> 22 CCR 2650 Recordin re orcin of unauthorized releases <br /> 23 CCR 2715 Desi nated O erator:(a Statement from UST oner, c-e Monthlyinspection; f)Employee trainin Ml <br /> 24 CCR 2638 al-----------n ca Annuertification w <br /> 25 CCR 2638(a) Annual line leak detector test <br /> 26 HSC 25284.2 Annual s ill containment testing (MI <br /> 27 CCR 2636 4 Annual line tightness test <br /> 28 CCR 2661 (f) Re air for tank/ i in has had tightness test Ml <br /> 29 CCR 2643 a Biennial it hmess test of gravit i in re-Januar 1, 1984 M2 <br /> 30 . .CCR 2643 d) Triennialfin etest for conventional suction.piping re-Jams 1, 1984 <br /> 31 HSC 25292.5 Double walls stem located within 1000'of ublic well-ELD (Ml <br /> 32 CCR 2661 - Permit to re it UST s stem <br /> 33 HSC 25286 a Permit to all monitorin s stem <br /> 34 _HSC 25298 Permit[o to oraril close UST s stem <br /> 35 HSC 25298 c I Pemvt to close UST s stem <br /> 36 HSC 25299(a 9 Disablin leakdetection devices <br /> 37 HSC 25298 a Ille al abandonment of UST s stem <br /> 38 Other: <br /> EHD INSPECTOR: <br /> PHONE: <br /> 9 Lt 6 603' ulc <br /> 20 Septic system <br /> RECEIVED BY: <br /> TITLE: C Serves>20 people/day <br /> 'I Receives er <br /> t _Other disposal methodsan sanitary waste <br /> D wells/French Drains <br /> F,HD 23-02-002 <br />