Laserfiche WebLink
SAN .JOAQUIN COUNTY <br /> tzNVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, California 95202-3029 <br /> Telephone: (209), 468-3420 Fax: (209)468-3433 Web:www.smgov.org/ehd <br /> UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection <br /> l Date: <br /> _I LX,-, �Y�$h�r� <br /> Facility address: UST# -110 <br /> G� ��v����NV Product <br /> Facility Contact: Title: Phone: �l <br /> , " ITS v.ti.►� <br /> Monitring an I: I Pi ing system: Overfill prevention: <br /> V�� ressurized ❑Suction G GravityV r"echanical 0 Audible/visual <br /> Inspection type: Violations: <br /> ARoutineonitoring Certification Installation ❑Other: M1-RDetect LlM2-RPrev 0 M-3 Both <br /> VIOLATIONS) HSC=California Health & Safety Code; CCR=California 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 / MWdW1IW AIM \1 OK <br /> 5 CCR 2632 b Monitoring Program (Monitoring & Response Plan is current and approved by the local agency. jj. <br /> 6 CCR 2712 i Monitoring Ian is onsite. u <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 M1) <br /> 11 CCR 2630 d UST system monitoring equipment is properly located to detect a leak M1 <br /> 12 HSC 25291 b UST s stem monitoring equipment isoperational - A4 jis ` M1) <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping& UDC is preent M1 <br /> 14 CCR 2631 a Primary containment is product tight <br /> + 15 HSC 25291 (a)(2) Secondary containment for UST is tight 51t. �p B`7 z6e hA <br /> 16 CCR 2636 (c)(1) All releases in seconds piping flow 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 Atraining <br /> 20 CCR 2636 (a) Conventional suction piping shall have continuous monitoring&20 containment <br /> a 21 HSC 25291 (e) Water in 20 containment analyzed & properly disposed ofd >L (STNWI :22 CCR 2650 Recordin /re ortin of unauthorized releases s 23 CCR 2715 Desi nated O erator: a Statement from UST owner; c Monthl ins ection; Em to e <br /> 24 CCR 2638 a Annual monitoring certificationP5—�!°t-01 ` <br /> 25 CCR 2638 a Annual line leak detector test - M1 <br /> 26 HSC 25284.2 Annuals ill containment testing -0"7 <br /> AW <br /> 27 CCR 2636 4 Annual line tightness test M1 <br /> 28 CCR 2661 Repair for tank/piping has had tightness test (M2 <br /> 29 CCR 2643 e Biennial tightness test of gravity pipingre-Janus 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping (pre-Janus 1, 1984) (M1) <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 /> E35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299 Disabling leak detection devices ll__ <br /> a 9 2 �J <br /> 37 HSC 25298 a Ille al abandonment of UST system <br /> 38 Other: <br /> EHDINSPECTOR- PHONE: n / UIC <br /> -� �� '✓�./�� Septic system <br /> v ( - I Serves>_20 people/day <br /> DEM \�j TITLE: i Receives other than sanitary waste <br /> %4 j ` Other disposal methods: <br /> Dry wells/French Drains <br /> EHD 23-02-002 REV 8/08 <br />