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I _ DATE \ a O\ <br /> r VA PR# =\ <br /> PUwLIC HEALTH SERVICES SAN JOAQUIN COUNTY PAGE \ of 3 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E. Weber Ave., Third Floor, Stockton, CA 95202 <br /> (209)468-3420 <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility Name RG!� Facility Addressa"tOss\ \R\N.\\O�a,. 94o-\ -'C� CN <br /> Facilty Contact N�V� Vk-\"VeRL TitleIWAN�Cc%z�►►.xrc KG%- Phone # <br /> UST# 5 Product &U\� UST#Prod.uct4\Fs7EL UST#_Product UST# Product <br /> OVERFILL PREVENTION: ❑Audible/VisualI Mechanical Monitoring PJ;aJ�nel: Mam. t.i�_zc:c <br /> PIPING SYSTEM: C Gravity C Pressure (Suction Violations: M Minor C Major <br /> AUTOMATIC PUMP SHVT DOWNSATISFIES CCR 2636 (g): C Yes E/No <br /> INSPECTION TYPE: gRoutine 61Monitoring Certification CComplaint []Install CRemoval=r�:ZC� <br /> COMPANY NAME: <br /> E.Gw� .�� TECHNICIAN NAME:C�6 CSpS�\�•+£.a.�-� PHONE: <br /> VIOLATION(S) <br /> The above facility is not in compliance with the following section(s) of Health & Safety Code (HSC) and/or <br /> California Code of Regulations (CCR): <br /> 1 HSC 25284 Permit to operate <br /> 17—CCR 2650 Recording/reporting <br /> / unauthorized release <br /> 2 CCR 2637 Secondary Cont. Testing 18 / CCR 2632 (d) Monitoring & response plan <br /> 3CCR 2711(b)& (c) Current State Forms A& B 19��CCR 2712 (i) Monitoring & response plan <br /> 4 HSC 25292.2 Certification of financial is on site <br /> responsibility and letter from 20 CCR 2712 (b) Maintenance &monitoring <br /> chief financial officer records <br /> 5 CCR 2630 (d) Continuous monitoring 21 CCR 2636 (f)(4) Annual line tightness test <br /> system for UST system 22CCR 2630 (d) Annual line leak detector test <br /> 6 CCR 2636 (c)(1) All releases in secondary 23 CCR 2630(d) Annual monitoring <br /> piping Flow to a collection certification <br /> sump 24 CCR 2643 (d) Daily monitoring of suction <br /> 7 CCR 2636 (a) Secondary containment for piping that is not <br /> piping is waterproof continuously monitored <br /> 8 HSC 25291 (f) Automatic line leak 25CCR2643 (d) <br /> detector(s) Triennial tightness test of <br /> 9 suction CCR 2636 (f)(1) Continuous monitoring piping that is not <br /> system for underground continuously monitored <br /> 26_CCR 2643 (e) Biennial tightness test of <br /> piping gravity piping that is not <br /> 10—CCR 2632 (c)(2) Continuous monitoring <br /> system for UST continuously monitored <br /> 11 HSC 25291(a)(2) Secondary containment for 27—CCR 2662 Upgrade requirements for <br /> UST is tight UST system <br /> 12 CCR 2636 (f)(1) Continuous monitoring28—CCR 2661 Permit to repair UST system <br /> 29—HSC 25286 (a) Permit to alter monitoring <br /> system for dispenser system system <br /> 14 CCR 2635 (b)(1) Spill container 30 HSC 25298 (a) Illegal abandonment of UST <br /> CCR 2635 (b)(2) Overfill prevention system system <br /> 15 CCR 2631 (a) Primary containment is 31HSC25298 (b) Permit to temporarily close <br /> product-tight UST system <br /> 16—HSC 25292.1 UST system is operated to 32 HSC 25298 (c) Permit to close UST system <br /> prevent unauthorized release 33 Violation(s) not listed above <br /> EHD INSPECTOR: <br /> RECEIVED B T PHONE. _ \ <br />■ .Health-EORIGINAL - <br />