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• 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 slgov_ �ro/Phd <br /> Facility name: <br /> UNDERGROUND STORAGE TANK FUST PROGRAM INSPECTION REPORT <br /> P/ <br /> a1 L r:Designated Operator:�—f Inspection <br /> Facility address: �� /` / � Date: <br /> tili (' <br /> (� J ��'� UST# Mau /8 oq <br /> . <br /> Facility Contact: �`�� '� C "- <br /> Title: "Prod uct , <br /> Phone: O <br /> s , S eta <br /> Mgnitoring Panel: //s <br /> v �S 3s0 Piping system: <br /> Pressurized ❑Suction 0 ertill prevention: <br /> Inspection type: ❑Gravity <br /> echanical ❑Audible/visual <br /> outine Monitoring CertificationViolations: <br /> ❑Installation 11 Other: <br /> # Code Section VIOLATION(S) HSC=California Health&Safety Code; CCR=Califo n a Code of Regulations V R <br /> ❑M-3 Both <br /> 1 HSC 25284 Permit to V=Violation; RV=Re eat Violation <br /> 2 CCR 2637 o erste V <br /> est a <br /> 3 CCR 2711 b & c Current Uni edtPro anmtCOn olida ed Forms on file with EHD -acili and tank form <br /> 4 HSC 25292.2 Certification of financial res onsibili and CFO letter <br /> 5 CCR 2632 b MonitoringPro ram Monitorin IRS,es onse Plan is current and a roved b the local a enc . <br /> 6 CCR 2712 i Monitorin an is onsite. <br /> 7 CCR 2712 b Maintenance&monitorin records <br /> 8 CCR 2643 d Dail monitorin of suction i in re-Janua , 1, 1984 (M1 <br /> 9 HSC 25292.1 UST s stem iso eated to revent unauthorized release <br /> 10 CCR 2632 c 2 UST monitorings stem is resent <br /> 11 CCR 2630 d UST s stem monitorin a ui mentis <br /> 12 HSC 21 llocated to detect a leak (M1 <br /> 2529 b 1 UST s stem monitoring equipment iso erational M1 <br /> 13 CCR 2636 1 Continuous monitorin s stem for under round i in &UDC is resent (M1) <br /> 14 CCR 2631 a Prima containment is roduct ti ht M1) <br /> 15 HSC 25291 a 2 --Of X containment for UST is tight <br /> 16 CCR 2636 c 1 All releases in secondary pipingflaw to a collection sum <br /> 17 HSC 25291 f Line leak detector s are installed <br /> 18 CCR 2635 b 1 Spill container M1 <br /> 19 CCR 2635 b 2 Overfill I tention s stem (M2 <br /> 20 CCR 2636(a) Conventional suction eiping shall have continuous monitor!29&21 containment M2) <br /> 21 HSC 25291 (e) Water in 2°containment anal ed& ..E.—Ay..E.-Ay ulbpusea of <br /> 22 CCR 2650 Recording/repoltin of unauthorized releases <br /> 23 CCR 2715 Desi nated 0 erator: a Statement fromUST owner; c-e Monthlyinspection; Em to Ste tranin <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 1 CCR 2638 a Annual line leak detector test <br /> 26 1 HSC 25284.2 1 Annuals ill containment testing M1) <br /> 27 1 CCR 2636 4 Annual line ti htness test <br /> 28 CCR 26611 Repair for tank/pi pin has had tightness test M1 <br /> 29 CCR 2643 a Biennial tightness test of gravity pipingre-Janua 1, 1984 (M2) <br /> 30 CCR 2643 d Tdermal line test for conventional sucuu,i piping (pre-Janua 1, 1984) (M1) <br /> 31 HSC 25292.5 Double wall system located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to re air UST s stem <br /> 33 HSC 25286 a Permit to alter monitRorrig system <br /> 34 HSC 25298 b Permit to temporarilyclose UST Sys <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299 Disabling leak detection devices <br /> a 9 2 <br /> 37 HSC 25298 a Ille al abandonment of UST s stem <br /> 38 Other: <br /> EHD INSPECTO . <br /> PHONE: <br /> 4d/ <br /> b Septic system- 11.11CRECEIVE BY• ❑Serves>_20 people/day <br /> _ TITLE: ❑Receives other than sanitary waste <br /> tt' Other disposal methods <br /> D wells/French Drains <br /> EHD 23-02-002 REV 8/08 <br /> UST INSPECTION FINAL <br />