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U t <br /> \ SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1 304 East Weber Avenue, 3rd Floor, Stockton CA 95202-2708 <br /> \ 4 Telephone: (209)468-3420 Fax: 209 464-0138 Web: www.sjgov.org/ehd <br /> Facility name: UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Designated Operator: inspection Date. <br /> Facility address: <br /> Gus S z+ 01 <br /> UST# <br /> Product <br /> Facility Contact: Title: Plione: ' <br /> iYlonit ri 4'..' <br /> el: Piping system: Overfill prevention: <br /> Pressurized ❑Suction 0 Gravit 0 Mechanical udible/visualInspection ty Violations: <br /> Routine MonitoringCertification 11 Installation ❑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=Repeat Violation V <br /> 1 HSC 25284 Permit too crate <br /> 2 CCR 2637 Second containment test performed <br /> 3 CCR 2711 )&(c) Current Unified Pro ram 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 a enc <br /> 6 CCR 2712 i Monitoring&response plan is onsite <br /> 7 CCR 2712 b Maintenance&monitoring records M <br /> 8 CCR 2643 d Daily monitorin of suction pipinre-January, 1, 1984) d <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 I CCR 2630 d UST system monitorina equipment is properly located to detect a leak (M1 <br /> 12 HSC 25291 UST system monitoring equipment isoperational M2 <br /> 13 CCR 2636 1 Continuous monitoring system for underground 2iping&UDC is present (M1) <br /> 14 CCR 2631 a Primary containment is product ti ht <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 detector(s)are installed (Ml) <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 Recording/reporting of unauthorized releases M1 <br /> 23 CCR 2715 Designated Operator: a)Statement from UST owner; c-e onthl inspection; Em to ee 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 testin <br /> 27 CCR 2636(f)(4) Annual line tightness test (MI) <br /> 28 CCR 2661 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(pre-January1, 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 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) illegal abandonment of UST system <br /> 38 Other: <br /> Er 1NSP OR: PHONE UIC <br /> � Septicsyst_em: <br /> low F.Serves>_20 people/day <br /> R .CEIV Y.4 TITLE: ❑Receives other than sanitary waste <br /> /J Other disposal methods: <br /> ❑Dry wells/French Drains <br /> EHD 23-02 <br /> 113107 <br />