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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.secehd.com <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility <br />Name:A <br />Facility /� <br />Address:�(J �L ( <br />Inspectior� <br />Date: / <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR — Notice to Comply <br />UST System Observations V R COS <br />330 <br />CCR 2717.10 <br />Deposited petroleum into a red tagged UST (V746) ❑ ❑ ❑ <br />331 <br />HSC 25299(f)(2) <br />Tampered with or disabled leak detection devices or alarms (V692) ❑ ❑ ❑ <br />332 <br />CCR 2631.1 <br />UST system not compatible with the substance stored (V751) ❑ ❑ O <br />333 <br />HSC 25298(b) <br />Failed to comply with temporary closure requirements (V747) ❑ ❑ ❑ <br />334 <br />HSC 25298(c) <br />Failed to comply with permanent closure requirements (V748) ❑ ❑ ❑ <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR — Notice to Comply <br />Non -Pressurized Piping <br />V <br />R <br />COS <br />401 <br />CCR 2636(a)(3) <br />Suction piping not properly sloped or incorrectly located check valve (V705) <br />❑ <br />❑ <br />❑ <br />402 <br />CCR 2643(d) <br />Daily monitoring of suction pipe (pre -Jan 1984) not performed (V726) <br />❑ <br />❑ <br />❑ <br />403 <br />CCR 2643(d) <br />Triennial 0.1 gph line test for conventional suction piping not performed (pre -January 1984) (V664) <br />❑ <br />❑ <br />❑ <br />404 <br />CCR 2643(e) <br />Biennial 0.1 gph test for gravity piping not performed (pre -January 1984) (V665) <br />❑ <br />❑ <br />❑ <br />Other Violations <br />V <br />R <br />COS <br />2010 <br />See below <br />Unlisted Administration/Documentation violation (V736) <br />❑ <br />❑ <br />❑ <br />2030 <br />See below <br />Unlisted Operations/Maintenance violation (V743) <br />Cl <br />❑ <br />❑ <br />2060 <br />See below <br />Unlisted Design/Construction violation (V745) <br />❑ <br />❑ <br />❑ <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS II, or MINOR — Notice to Comply <br />1' <br />ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />Received by (signature): <br />Title: <br />Date: <br />Receiv inted name): <br />Ins ctor: <br />Inspector phone: <br />EHD 23-01 KV/08/07/15 " Page- o' UST INSPECTION REPORT <br />