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SAN JOAQUIN COUNTY <br /> �. •.off <br /> 2 ENVIRONMENTAL HEALTH DEPARTMENT <br /> ` 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> ° P Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sjgov.orglehd <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> Facility <br /> address: UST <br /> 2't 7Z�j IV Clw L -` 1Product _'V51L 10 qdo <br /> � I <br /> Facility Contact: Title: Phone: Q <br /> gAc tl 1 I S��crN 6 '— 333_2a�i <br /> pQpni 't arw�:M '�7 Piping system: Overfill prevention: / <br /> — Pressurized C Suction C GravityMechanical C Audible/visual <br /> Inspection type: iolations: <br /> Routine lemonitoring Certification C Installation C Other: C MI-RDetect C M2-RPrev C M-3 Both <br /> VIOLATION(S)HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit tooperate <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 c)(2)(D) Monitoring&response plan is current and filed with the local agency <br /> 6 CCR 2712 i Monitoring&response plan is onsite <br /> 7 CCR 2712 Maintenance&monitoring records M1 <br /> 8 CCR 2643 d Daily onitoring of suction i in re-Janua , 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 /> 1 I CCR 2630(d) UST system monitoring equipment is properlylocated to detect a leak (Ml <br /> 12 HSC 25291 UST system monitoring equipment isoperational M2 <br /> 13 CCR 2636(f)(1) Continuous monitoring system for underground piping&UDC is present (MI) <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 Ml) <br /> 18 CCR 2635 1 Spill container M2 <br /> 19 CCR 2635 2 Overfill prevention system (M2 <br /> 20 CCR 2636(a) Conventional suction Eiping shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases Ml <br /> 23 CCR 2715 -5—esignated Operator: a)Statement from UST owner; (c-e)Monthly inspection; Employee 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 testing <br /> 27 CCR 2636 4) Annual line tightness test (MI) <br /> 28 -CCR 2661 Repair for tank/piping has had tightness test 1142 <br /> 29 CCR 2643 e) Biennial tightness test of gravity piping( re-Januar 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction pi2ing(pre-January1, 1984 Ml <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELI) <br /> 32 CCR 2661 Permit to repair UST system <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) Disablin leak detection devices <br /> 37 HSC 25298 a Ille al abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> t' bey -2 y4 8 septic_ te <br /> ; m: <br /> ( (_(_� 'l b —�7 El Serves 220 people/day <br /> RECEIVED BY: TITLE: C Receives other than sanitary waste <br /> Other disposal methods' <br /> ❑Dry wells/French Drains <br /> EHD 23-02 <br /> 1/3/07 <br />