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UI <br /> CO <br /> . , ..� 0 SAN JOAQUIN COUNTY <br /> Q" ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3`1 Floor, Stockton, CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:wwwsjgov.org/ehd <br /> <lFORN <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> raid 03 S VOM I ib e '513101 <br /> Facilltj address: UST# R <br /> YD �- rvM Product U <br /> Faylity Contact: Title: Phone: <br /> Iftm Mom wovoff/ -to <br /> Monitor�g P?net: Piping sys m: (/U Overfill prevention: / <br /> -rchSU Pressurized ❑Suction1!❑ avlt echanicai ❑Audible/visual <br /> Inspection type: Violations: <br /> Routine IMonitoring Certification ❑Installation ❑Other: Ml-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATIONS) HSC=California Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section V <br /> V=Violation;RV=Re eat Violation <br /> 1 I HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 (b)& c Curtent Unified Pro am Consolidated Forms on file with EHD(Facilityand tank form <br /> 4 HSC 25292.2 Certification of financial re2onsibility and CFO letter se <br /> 5 CCR 2632 c 2 D) Monitoring&res onse plan is current and filed with the local agency <br /> 6 CCR 2712 i Monitoring&response plan is onsite <br /> 7 CCR 2712(b) Maintenance&monitoring records Ml <br /> ll <br /> 8 CCR 2643 d Daily monitoring of suction piping re-Januar , 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 Ml <br /> 11 CCR 2630 d) UST system monitoring equipment is properly located to detect a leak (Mill <br /> 12 HSC 25291 UST system monitoring equipment isoperational M2 <br /> 13 CCR 2636 f)(]) Continuous monitoring.system for underground piping&UDC is present (Mi) <br /> 14 CCR 2631 a Primary containment is product tight <br /> 7-5 – 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 detector(s)are installed (Mi) <br /> 18 CCR 2635 1 Spill container M2 <br /> 19 CCR 2635(b)(2) Overfill prevention system M2) <br /> 20 CCR 2636(a) Conventional suction pi2inE shall have continuous monitoring&20 containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting ofuthorized releases Ml <br /> ll N1 <br /> 23 CCR 2715 Designate O erator a atement from UST owner, c- Monthl ins ection; m to ee 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 testin <br /> 27 CCR 2636(f)(4) Annual line tightness test (MI) <br /> 28 CCR 2661 Repair for tank/piping has had tightness test M2 <br /> 29 CCR 2643 (e) Biennial tightness test of gravity pipingre-Jana 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping(pre-January1, 1984 Ml <br /> 31 HSC 25292.5 Double wall system located within 1000'of puhlic,well-ELD <br /> 32 CCR 2661 Permit to repair UST s stem <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) I Illegal abandonment of UST system <br /> 38 1 Other: <br /> EUD INSP CTOR: PHONE: UIC <br /> / Septic system: <br /> Wa ❑Serves>_20 people/day <br /> RE C TITL : ❑Receives other than sanitary waste <br /> Other disposal methods' <br /> (C e S �Q. Sy ❑Dry wells/French Drains <br /> EHD 23-02 <br /> 1/3/07 <br />