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SAN JOAQUIN COUNTY <br /> *NVIRONMENTAL HEALTH DEPARTMEN* <br /> 304 Weber Avenue, 3`d Floor, Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax: (209)468-3433 Web: www.sjgov.org/eh <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> A"e,b ?�,��,J.- * --)-4 0 7 6 r,,, 2,)-A;,-.� k-* U <br /> Facility address: UST <br /> 6 154t Product Q <br /> Fa iI.ty Contact: Title: Phone: <br /> S <br /> Monitoring Panel: .PPiiping system: Overfill prevention: <br /> 375-0 �Y Pressurized ❑Suction ❑Gravity echanical ❑Audible/visual <br /> Inspection type: Violations: ���°' <br /> 12outine ]Monitoring Certification 11 Installation F-1 Other: 11Ml-RDetect ElM2-RPrev �`M-3 Both <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section V <br /> V=Violation;RV=Re eat Violation <br /> I 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(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 isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present (M1) <br /> 1 1 CCR 2630(d) UST system monitoring equipment is properly located to detect a leak (M1) <br /> 12 HSC 25291 (b) UST system monitoring equipment isoperational M2) <br /> 13 CCR 2636 f)(1) Continuous monitoring system for underground 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 piping flow to a collection sum <br /> 17 HSC 25291 (f) Line leak detector(s)are installed (M1) <br /> 18 CCR 2635(b)(1) Spill container (M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system (M2 <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 ReCOTding/reporting of unauthorized releases M1 <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner• (c-1)Monthly ins ection;(f) mployee training <br /> 24 CCR 2638 a) Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (M1) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test (Ml) <br /> 28 1 CCR 2661 (f) Repair for tank/piping has had tightness test (MZ) <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 piping( re-January 1, 1984) (M1 <br /> 31 HSC 25292.5 Double walls stem located within 1000' of public well-ELD <br /> 32 CCR 2661 Permit to re 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) Disabling leak detection devices <br /> 37 HSC 25298(a) Illegal abandonment of UST system <br /> 38 Other: <br /> E D INSP CTOR PHONE: UIC <br /> 6 �� � otic system <br /> zo ❑Serves>_20pe p <br /> E�'EIVFD BY: y�� TITLE: f Receives r than sanitary waste <br /> �j-y� Other dis methods: <br /> v ry wells/French Drains <br /> Peps <br /> FBD 23-02-002 <br />