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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENA <br /> 304 Weber Avenue, 3rd Floor, Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sigov.orp/ehd <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> IWNFT--r ZALPcV S&OO ILRIAF-1 ei-Lswofc-" oy—t9-06 <br /> Facility address: UST# I <br /> IKT7 tJ ' w t lf�p�1 vrl1,Y Product $9 �( <br /> Facility Contact: Title: Phone: , <br /> COD SIS 65"X621 , <br /> .IoF4+rS ^�.e�C(FC4-- <br /> C0µ 46Ss3s9 <br /> Monitoring Panel: Pi ing system: Overfill prevention: <br /> TL - SO Pressurized ❑Suction ❑Oravity ❑Mechanical Audible/visual <br /> Inspection type: Violations: <br /> Routine ;?(Monitoring Certification ❑Installation ❑Other: ❑MI-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=Califar is Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section 8 <br /> V=Violation;RV=Re eat Violation V <br /> I HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test'performed <br /> 3 CCR 2711 6 & c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br /> 4 'HSC 25292.2 Certification offinancial responsibility and CFO letter y <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 pplan is onsite. <br /> 7 CCR 2712 6 Maintenance&monitoring records MI <br /> 8' : CCR 2643(d) Daily monitoring of suction piping(pre-January, t, 1984 <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present Ml <br /> 11 CCR 2630 d UST system monitoring equipment is properly located to detect a leak MI <br /> 12 HSC 25291 UST system monitoring equipment isoperational M2 <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping&UDC is present Ml <br /> 14 CCR 2631 a Primary.containment is product tight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CUR 2636(c)(1) All releases in secondary pipingg flow to a collection sum <br /> 17 HSC 25291 Line leak detectors 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&20 containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of g' <br /> ,22 CCR 2650 Recording/reporting of unauthorized releases Ml <br /> 23 CCR 2715 Desi nated Operator: a)Statement from UST owner; (c-c)Monthly inspection; 0 Employee training <br /> 24 CCR'2638 a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (MI) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test Ml <br /> 28 CCR 2661 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( re-Jams 1,1984) (MI) <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 Permit to temporarilyy 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 /> EHD INSPECTOR: PHONE: UIC <br /> Lo R{ LQCA6 s >Lvq. q Ie, 3,k Septic system: <br /> Serves>_20 people/day <br /> RECEIVED BY: TITLE: C ❑Receives other than sanitary waste <br /> Other dishhods, <br /> Dry wells/French Drains <br /> F.HD 23-02-002 <br />