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N, 1/y <br /> �°:a., SAN JOAQUIN COUNTY <br /> G <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> AAA" � rd , Stockton, CA 95202-2708 <br /> V. Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: e< InspF <br /> n Date: <br /> l�S A c16 f-gci ��h Lzc� y � l6 <br /> Facility address: UST <br /> Product D 1 <br /> Facility Contact: Title: Phone: " <br /> cn �tl RJ V G rb <br /> Monitoring anel: Piping system: Overfill prevention: eQ,l/l 0 LI <br /> Pressurized ❑Suction ❑Gravity echanical _ Audible/visual <br /> Inspection type: Violations: X10 6� e,• l e(,��., <br /> Routine VMonitoring Certification ElInstallation ElOther: ❑ht 1-12Detect ❑M?-RPrcv ❑M-3 Both <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section V <br /> V=Violation;RV=Re eat 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(c)2 (D) Monitoring&response plan is current and filed with the local agency <br /> 6 CCR 2712 i Monitoring&response plan is onsite <br /> 7 CCR 2712 b Maintenance&monitoring records (M1) <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 present (MI) <br /> 11 CCR 2630(d) UST system monitoring equipment is properly located to detect a leak (MI) <br /> 12 HSC 25291 b UST system monitoring equipment isoperational (M2) <br /> 13 CCR 2636(f)(1) Continuous monitoring system for underground piping&UDC is present (MI) <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 piping flow to a collection sum <br /> 17 HSC 25291 Line leak detector(s)are installed <br /> 18 CCR 2635(b)(1) Spill container (n12) <br /> 19 CCR 2635(b)(2) Overfill prevention system 117) <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of nauthorized releases ( l 1) <br /> 23 CCR 2715 Designated O erator (a) tatement from UST owner; (c-e)Monthly ins ection (f) m loyee training <br /> 24 CCR 2638 a Annual monitoring;ce tfication <br /> 25 CCR 2638(a Annual line leak detector test (MI) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test (M1) <br /> 28 CCR 2661 Repair for tank/piping has had tightness test (n12) <br /> 29 CCR 2643 (e) Biennial tightness test of gravity piping( re-Januar 1, 1984) <br /> 30 CCR 2643 d Triennial line test for conventional suction piping(pre-January1, 1984) (N1 l) <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 HSC 25298(c) Permit to close UST system <br /> PEHD <br /> HSC 25299(a)(9) Disablingleak detection devices <br /> HSC 25298 a Illegal abandonment of UST system <br /> Other: <br /> NSPECTOR: PHONE: UIC <br /> S tic tem: <br /> 124 �� 11 Serve <br /> 0 people/day <br /> RECEIVED BY: TITLE: ❑Receives o than sanitary waste <br /> Other disRDosal metho <br /> '-MaAA4 ❑Dry wells/French D 'ns <br /> EHD 23-02 <br /> 1/3/07 <br />