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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:www.sigov.or <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Faeili name: Designated Operator: Inspection Date: <br /> C�M�W-" tj�� �0�%kw <br /> Facilitv address: /� /� p� LIST# C� 7 <br /> • 'f°VUn�C� � . W ')6() 1� Product 117 <br /> ! <br /> Facility Contact: Title: Phone: Q <br /> J\L <br /> Monitorin Pa el: Piping system: Overfill prevention: <br /> IFW- LII Pressurized ElSuction L:GravityX'Ntechanical ❑AudibleJvisual <br /> Inspection type: Violations: 11 <br /> Routine NNIonitoring Certification ❑Installation ❑Other: ❑MI-RDetect ❑M2-RPrev -3 Both <br /> # Code Section <br /> VIOLATIONS) HSC=California Health&Safety Code;CCR=California Code of Regulations V R V=Violation;RV=Re eat Violation V <br /> I HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test performed 1- _o6 <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 Program(Monitoring&Response Plan is current and approved by the local agency. <br /> 6 CCR 2712 i) Monitoring plan is onsite. <br /> 7 CCR 2712 b Maintenance&monitoring records M1 <br /> 8 CCR 2643 d Daily monitoring of suction piping(pre-January, I, 1984) <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present (M1) <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(t)(1) Continuous monitoring system for underground piping&UD is present M1 <br /> 14 1 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 M1 <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 2°containment analyied&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases M1 <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; - Monthly ins ection; t Em to ee training <br /> 24 CCR 2638 a Annual monitoring certification -$ <br /> 25 1 CCR 2638 a) Annual line leak detector test lo-t$-61 (M 1) <br /> 26 HSC 25284.2 Annuals ill containment testing V)-18-01 <br /> 27 CCR 2636 4) Annual line tightness test 1041-01 M1) <br /> 28 CCR 2661 Repair for tank/piping has 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) M1) <br /> 31 1 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 /> 36 HSC 25299(a)(9) Disabling leak detection devices _ <br /> 37 1 HSC 25298 a) I Illegal abandonment of UST system <br /> 38 1 Other: <br /> EHD IDI SJR: �) � PHONE r _ UIC <br /> Septic system: <br /> Serves>_20 people/day <br /> RECEIVED BY: TITLE: —Receives other than sanitary waste <br /> I Other disposal methods: <br /> Dry wells/French Drains <br /> EHD 23-02-002 REV 05/07 <br />