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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:mL% .5jgQ-y.org/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> Facility address: UST# <br /> ''nni�tt + �, q <br /> tl,' ----- — — -- % Product <br /> Facilitv Contact: l'itle: Phone: <br /> i <br /> onitoring Panel Pi ing system: J � 0 ertill prevention: <br /> Pressurized El Suction Gravity i Mechanical Audible/visual <br /> 71pection type: Violations: <br /> Routine Monitoring Certification ❑Installation ❑Other: f;MI-RDetect ❑M2-RPrev I i M-3 Both <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section V <br /> V=Violation;RV=Repeat Violation <br /> 1 HSC 25284 Permit tooperate <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 Pro (Monitoring&Response Planis current and approved by the local agency. <br /> 6 CCR 2712 i) Monitoring plan is onsite. <br /> 7 CCR 2712 b Maintenance&monitoring records (M 1) <br /> 8 CCR 2643 d) Daily monitoring of suction piping(pre-January, 1, 1984 <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is preseEt (M 1) <br /> 11 CCR 2630 d UST system monitoring equipment is properly located to detect a leak (M 1) <br /> 12 HSC 25291 b UST system monitoring equipment isoperational (M2) <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping&UDC is present (M 1) <br /> 14 CCR 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 HSC 25291 Line leak detector(s) are installed (M 1) <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 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases (M 1) <br /> 23 CCR 2715 DesignatedOperator:(a)Statement from UST owner; (c-e)Monthly inspection;(t) Em loyec training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638 a) Annual line leak detector test (M 1) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test (M 1) <br /> 28 CCR 2661 f) Repair for tank/pipinghas had tightness test (M2) <br /> 29 CCR 2643 e) Biennial tightness test of gravity piping(pre-January 1, 1984) <br /> 30 CCR 2643 d) Triennial line test for conventional suction piping(pre-January 1, 1984) (M 1) <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 1 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 INS CTOR: PHONE: oUIC <br /> C � � tic system: <br /> VA <br /> (� N0 —Serves>_20 people/day <br /> RFG IVEDBY TITLE: —Receivesotherthansanitarywaste <br /> Other disposal methods: <br /> I Dry wells/French Drains <br /> EHD 23-02-002 REV 0S 07 <br />