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DATE <br /> SAN JOAQUIN COUNTY oR# <br /> ENVIRONMENTAL HEALTH DEPARTMENT PACE �. <br /> 304 E. Weber Ave„Third Floor, Stockton, CA 95202 <br /> (M)468-3420 <br /> UNDERGROUND STORAGE TANK(UST) PPOGRAM INSPECTFON REPORT <br /> Facility Name Facility AddressLa <br /> Facilty Contact S 7'A Title Phone# <br /> UST `_�_ Product�i UST#_�Product UST#aProduct_ ,UST# Prodict_� <br /> Overfill Prevention: ❑Audibla/Visual gmeohanical Monitoring Panel:V <br /> Piping System: Gesvi:y Pressure E Suction Violations: inor ❑Malcr <br /> Automatic Pump Shut D wn Sa i fies CCR 2636 g : Yea C No Dis anser Pan: }`es C No' <br /> INSPECTION TYPE: TAoutire p0onitoring Certificatlon CCowlaint Llnstall CRemovel 7jRepa1WUpgrada <br /> COMPANY NAME: TECHNICIAN NAME: PHONE:--IJ <br /> VIOLATION(S) <br /> The above facility ;s not in cornpliance with the following section(s) of Health & Safety Code (HSC) and/or <br /> California Code of Regulations (CCR): <br /> 1 HSC 25234 Permit to operate 20 CCR 2712(bj Ir:aintenance& morito.-lrg <br /> 2 CCR 2.637 Secondary cant testing(6 records <br /> / rrlont.%'36 month) 21 CCR 2536(f)(4) Annusi line tightness test <br /> 3 V CCR 2711(b)&(c) Current State Forms A&B 220CR 2830(d) Annual line leak detector tsst <br /> 4 HSC 252,9.2.2 Certification of financial 23 CCR 2630(d) Annual monitoring eertfication <br /> responsibility and letter from 24 CCR 2543 (d) Dai y monitoring of suction <br /> chief financial officer piping that is not continuously <br /> 5� CCR 2630(d) Continuous monitoring systern monitored <br /> for UST system 25 CCR 2536(a) Conventional suction piping <br /> 6 CCR 2636(c)(1) All releases in secondarW piping shall have confi.nuous <br /> flow to a collection sump monitoring&20 containment <br /> 7 � HSC 25291 (a) Water in secondary(2')cont 26 CCR 2643 (e) Biennia' tightness last of gravit' <br /> 8 HSC 25291 (f) Automatic line leak detector(s) piping that is not cantin°uousiy <br /> 9 CCR 2636 (f)(1) Continuous monitoring system i monitored <br /> for underground piping 27 CCR 2662 Upgrade requirements for UST <br /> 10 CCR 2632 (c)(2) Continuous mor itorng system system <br /> for UST 28 CCR 2651 Permit to repair UST$yster, <br /> 11__ NSC 25291(a)(2) Secondary containment for 29 FISC 25286 (a, Permit to alter monitoring <br /> US7 is tight system <br /> 12CCR 2636(f;(1) Cortinuous monitoring system 30 HSC 2,5298(a) Illegal abandonment o`UST <br /> for dispenser system system <br /> 13 CCR 2635(b)(1) Spill container 31 HSC 25298 (b) Permit to temporarily close uS" <br /> 14 CCR 2635(b)(2) Overfill prevention system system <br /> 15 CCR 2631 (a) Primary containment is produwt- 32 HSC 25298 (c) Permit to close UST system <br /> tight 1G HSC 25292.1 UST system is operated to Z3 HSC 25291 (e) :relater in 2°cont analyzed and <br /> properly dispceed of <br /> prevent unautho•zed release 34 CCR 2640 (e) Single wall component within <br /> '17 CCR 2650 Recording/reporting 1000'of Public Weil; no ELD <br /> unauthorized release 35 CCR 2835(9)(2)(A)Cathodic protection testing <br /> 18 CCR 2632 (d) Monitorlrg&response plan 36�F'&SC 25299(6){9)Disabl ng leak Detect, devicas <br /> 19 CCR 2712 (i) Monitoring& response plan is 37 Vioiation(s)not listed above <br /> on site <br /> EHD INSPECTOR: PHONE,4 � <br /> RECEIVED BY: 7 1! TITLE: <br /> UNMINUST/INSP 1'cv 7/24102) <br /> Z� 30�dd 6000A HMA EEbE85t,612Z TE:EO E0i2Z/_T/T0 <br />