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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, California 95202-3029 Telephone:(209)468-3420 Fax:(209) 468-3433 Web:www.sigov.or_q/ehd/unitiii.html UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT Facility name: Inspection date: OA Facility address: p UST#/ �W►,IK1 v Product Fatility contact: e: Phone: M i ring 1AP iping tem: verfill prevention: Violations: Pressurized o Suction 0 Gravity echanical [iMt-RDetect 0 M2-RPrev i13-Both ❑Audible/visual Inspection type: Designated operator: ICC exp.date: /Routine 94onitoring Certification ❑Installation ❑Other. nr l On site Service Technician's name: 1C,.7d! Manu fa turer•s I g• VIOLATIONSR # Code Section HSC=CA Health&Safe Code;CCR=CA Code of Regulations;V=Violation; RV=Re at Violation V V 1 HSC 25284 No permit tooperate Secondary containment: (a)test not performed; (e)test report not submitted within 30 days;(f)test 2 CCR 2637 notification not providedo th te Environmental Health Department(EHD)at least 48 hours prior to conducting the test 3 CCR 2711 b Current Unified Program Consolidated Forms not on file with the EHD (Facility and tank form 4 HSC 25292.2 Current financial responsibilily documents not on file with the EHD 5 CCR 2632(b) MonitoringProgram(Monitoring&Response Plans is not current ora roved b the EHD 6 CCR 2712(i) Monitoring plan, response plan,and/oroperating permit and all conditions not onsite Maintenance&monitoring records not maintained 3 years,cathodic protection records for 6'/z (M1) years,written performance claims pertaining to release detection systems for 5 years,or records of repairs,linings, and upgrades for the life of the tank. Monitoring records include: (1)date and time Of 7 CCR 2712(b) all monitoring or sampling; (2) monitoring equipment calibration and maintenance records;(3) results of any visual observations; (4)results of sample analysis performed a lab or in the field; (5) logs of all readings of gauges or other monitoring equipment,ground water elevations,or other test results;(6) results of inventory readings and reconciliations 8 1 CCR 2643(d) Daily monitoring of suction piping(pre-January1, 1984 not performed M(M 9 HSC 25292.1 UST system is not operated to prevent unauthorized release, includingspills and over 10 CCR 2632 c 2 Monitoringsystem is not resent in the interstitials ace of a double walled UST 11 CCR 2630(d) UST monitoringa ui ment is not installed or maintained to detect a leak at the earnes 12 HSC 25291(b) UST monitoring system incapable of detecting leak from primary containment into seccontainment 13 CCR 2636(f)(1) Failed to maintain a continuous monitoring system far underground piping&UDCs than audible and visual alarm or sto s flow of roduct at the dis enser when it detects 14 CCR 2631 a Primary containment is not product tight 15 1 HSC 25291(a)(2) Secondary containment for UST system is not tight 16 CCR 2636(c)(1) All releases in secondary pipingdo not flow to a collection sum 17 CCR 2636(f)(2) Line leak detectors not installed or failed to detect a 3 allon per hour leak at 10 psi M1 18 CCR 2635(b)(1) Spill container failed to contain a minimum capacity of five gallons,or failed to provide a means (M2) to keep the spill container empty 19 CCR 2635(b)(2) Overfill prevention system was overridden or failed to meet overfill requirements in this section M2 20 CCR 2636(a) Failed to have secondary containment for piping (includes conventional suction piping) (11112 21 HSC 25291 a Water in 20 containment not removed,analyzed&properly disposed of Unauthorized release that: (c)did not escape secondary containment and cleaned up within eight (M1) 22 CCR 2650 hours was not recorded;(e)escaped secondary containment,not cleaned up after eight hours, or a sudden loss of product was not reported to the EHD within 24 hours 23aCCR 2715 a Failed to inform the EHD of a change of designated operator within 30 days 23b CCR 2715(b) Designated operator did not possess a current ICC UST System Operator certification EHD inspector. Rived by: Title: I Tude, ( N EHD 23-02-002 REV 06/28/10 P ge 1 UST INSPECTION REPORT