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SAN JOAQUIN COUNTY <br /> OVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, California 95202-3029 <br /> Telephone: (209)468-3420 Fax:(209)468-3433 Web:www.sigov.org/ehd <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection <br /> 'V\ I I Date: <br /> Gl <br /> R„ /?,/ /b jb$ <br /> Facility address: UST# <br /> �4`�c1J Lam} ."Product <br /> Facility Contact: Title: Phone: <br /> 1944� 2,o9 23-I-2-?t7 <br /> Monitoring Panel: VI Piping system: Overfill prevention: <br /> 145ressurized D Suction D Gravity N1 echanical D Audible/visual <br /> Inspection type: Violations: <br /> EKoutine Ewonitoring Certification D Installation D Other: D Mi-RDetect D M2-RPrev D M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC=Califomia Health &Safety Code; CCR=California Code of Regulations V R V=Violation; RV=Re eat Violation V <br /> 1 HSC 25284 Permit to operate <br /> 2 CCR 2637 Secondary containment test performed <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 b Monitoring Program (Monitoring& Response Plan is current and approved by the local agency. <br /> X <br /> 6 CCR 2712 i Monitoring Ian is onsite. <br /> 7 CCR 2712 b Maintenance&monitoring records M1 <br /> 8 CCR 2643 d Daily monitoring of suction piping (pre-January, 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 M1 <br /> 11 CCR 2630 d UST system monitoring equipment is properly located to detect a leak M1 <br /> 12 HSC 25291 b UST system monitoring a ui ment isoperational M7 <br /> 13 CCR 2636 1 Continuous monitoring system for under round piping& UDC is present M1 <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 M1 <br /> 18 CCR 2635(b)(1) Spill container 11112 <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 20 containment analyzed& properly disposed of <br /> 22 1 CCR 2650 Recording/reporting of unauthorized releases M1 <br /> 23 1 CCR 2715 Designated Operator: Statement from UST owner; (c-e)Monthly inspection; Employee training <br /> 24 1 CCR 2638 a Annual monitoring certification <br /> 25 1 CCR 2638 a Annual line leak detector test M1 <br /> 26 1 HSC 25284.2 Annuals ill containment testing <br /> 27 1 CCR 2636 4 Annual line tightness test M1 <br /> 28 CCR 2661 Repair for tank/piping has had tightness test M2 <br /> 29 CCR 2643 a Biennial tightness test of gravity piping (pre-January 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping (pre-January1, 1984 M1 <br /> 31 HSC 25292.5 Double walls stem located within 1000'of ublic well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 34 HSC 25298 b Permit to temporarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299 Disabling leak detection devices <br /> a 8 2 <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other: _ <br /> EHD INSP CTOR: PHONE: 3� Septic system <br /> UIC <br /> iV W — Ll Serves>!20 <br /> people/day <br /> RECEIVED B TITLE: ❑Receives other than sanitary waste <br /> Other disposal methods: <br /> ❑Dry wells/French Drains <br /> EHD 23-02-002 REV 6/06 <br />