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SAN.JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DFPARTMEN 1 <br /> 600 East Main Street, Stockton, California 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209)468-3433 Web:www.sogov.org/ehd <br /> UNDERGROUND STORAGE TANK (USTJ PROGRAM INSPECTION REPORT <br /> Facility name: Designated p erator: Inspection <br /> n (j7A,r`-'j 6UV� �'� Date <br /> er -Z,0-0-j iS c) f 4f 1-22 - S 6 0 <br /> Facility address: UST# _- I <br /> Ito Lo /) /- .- <br /> 'Product <br /> Facility Contact: Title: Phone: <br /> TO � l S Sr. u- a Sju. 071 72`3- R 7 f <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> N1Q!`C pressurized ❑Suction ❑Gravity 51 Mechanical udiblelvisual <br /> Inspection type: Violations: <br /> Routine onitoring Certification ❑Installation CJ Other: ❑M1-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section VIOLATION(S) HSC=California Health & Safety Code;CCR=California Code of Regulations V R <br /> 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 fhe local agency. <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 iso grated to prevent unauthorized release <br /> 10 CCR 2632 (c)(2) UST monitorings stem 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 equipment is operational (M1) <br /> 13 CCR 2636 (f)(1) Continuous monitorings stem for underground piping & UDC is present (M1) <br /> 14 GGR 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 NSC 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 &21 containment <br /> 21 HSC 25291 (e) Water in 21 containment anal ed & properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases (M1) <br /> 23 CCR 2715 Designated Operator: a Statement from UST owner; c-e lonthly inspection; f Employee 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 M7) <br /> 28 CCR 2661 f Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643 a Biennial tightness test of gravity pipingre-Janus 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping (pre-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 repair UST system <br /> 33 j HSC 25286 a Permit to alter monitoring system <br /> 34 HSC 25298 b Permit to temporarily close UST system <br /> 35 1 HSC 25298 c Permit to close UST system <br /> LOthe36 HSC 25299 Disabling leak detection devices <br /> a 9 f 2 <br /> 37 HSC 25298 a ills al abandonment of UST system <br /> 38 <br /> r: <br /> EHD INSPECTOR: PHONE: UIC <br /> s6 <br /> tf14J L Ue 146 9— j8q� sic system: <br /> ❑Sdrves>_20 peopleiday <br /> RECEWPE ) Y: TITLE: ❑Receives other than sanitary waste <br /> Other dis oral methods: <br /> ❑Dry wells/French-9fig4ns <br /> EHD 23-02-002 REV 8108 <br />