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6 SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street,Stockton,California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sigov.org/elid <br /> UNDERGROUND STORAGE TANK US PROGRAM INSPECTION REPORT <br /> Des r ted Operator: Inspection Date: <br /> Facility name:'/ _/ 1 -n{ i FN-✓, 16I'C.IO� <br /> USTri , <br /> Facility address: <br /> 3 I lJ Product <br /> Facility Contact: Title: Phone: _ �� I - � ' <br /> 1'0 t' S Lrr� <br /> Monitoring P eel: Piping system: <br /> Overfi6 prevention: <br /> ❑Pressurized ❑Suction Gmvi ❑Mechanical Audible/visual <br /> Violations: <br /> Inspection type: <br /> ❑MI-RDetect ❑M2-RPrev ❑M-3 Both <br /> El Routine Monitorin Certification ❑Installation ❑Other Y R <br /> # Code Section <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=Califomia Code of Regulations V <br /> V=Violation;RV=Re at Violation <br /> 1 HSC 25284 Permit to o erste <br /> 2 CCR 2637 Secondary containment test erformed <br /> 3 CCR 2711 b & c Current Unified Pmgram Consolidated Fortes on file with EHD(Facility and tank form <br /> 4 HSC 25292.2 Certification of financial reMonsibilLty and CFO letter <br /> 5 CCR 2632 b Monitorin Program Monitorin &Res onse Plan)is current and a roved b the local agency, <br /> 6 CCR 2712 i Monitoring Ian is onsite. Ml <br /> 7 CCR 2712 b Maintenance&monitoring records <br /> 8 CCR 2643 d Dail monitorin of suction i in re-Jams , I, 1984) <br /> 9 HSC 25292.1 UST s stem is o emted to revert unauthorized release (Mi) <br /> 10 CCR 2632 c)(2 UST monitorin -tern is present Ml <br /> I I CCR 2630 d UST s stem monitoring equipment is properly located to detect a leak (MZ) <br /> 12 HSC 25291 UST s stem monitoringequipment iso erational Ml <br /> 13 CCR 2636 1 Continuous monitoring system for under nand i in &UDC is present <br /> 14 CCR 2631 a Prim containment is prMuca tight <br /> 15 HSC 25291 a 21 Second containment for UST is ti ht <br /> 16 CCR 2636 c) 1) All releases in secondary pipingflow to a collection sum Ml) <br /> 17 HSC 25291 Line leak rl&ecto s are installed (M2) <br /> 18 CCR 2635 b) 1) S ill container M2) <br /> 19 CCR 2635 b 2 Overfill revention system <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitorin &2°containment <br /> 21 HSC 25291 (e) Water in 2a containment analyzed&properly disposed of 1 <br /> 22 CCR 2650 Recordin orcin of unauthorized releases <br /> 23 CCR 2715 Desi ated erntor: a)Statement from UST owner; kc-e)Monthl inspection; t)Em to ee trainin <br /> 24 CCR 2638 a Annual monitorin certification (Ml) <br /> 25 CCR 2638 a) Annual line leak detector test <br /> 26 HSC 25284.2 Annual s ill containment testing MI) <br /> 27 CCR 2636 4 Annual line ti Inness test (M2) <br /> 28 CCR 2661 (f) R air for tank/piping has had ti mess test <br /> 29 CCR 2643 a Biennial tightness test of gravityi in re-.... .... <br /> anus 1, 1984 <br /> 30 CCR 2643 d) Triennial line test for conventional suction.... .nre-Janus 1, 1984) (MI) <br /> 31 HSC 25292.5 Double wall s stem located within 1000' of ublic well-ELD <br /> 32 CCA 2661 Permit to r air 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 a)9) Disablin leak detection devices <br /> 37 HSC 25298 a Ble al abandonment of UST system <br /> 38 1 Other: UIC <br /> EHD INSPECTOR: PHONE: (� <br /> 6 „ d (�/n S he tem: <br /> 24 O , 1 <br /> (? e) ��j 7J l v�j -Sery es people/daythan <br /> r�{� <br /> RECEIVED BY: N TITLE: Receives er than sanitary waStE <br /> Other dis sal me 7i0 <br /> �,� �/!/✓K � - wells/French ' s <br /> EHD 23-02-002 REV 05/07 <br />