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s <br /> �- X. -, , , a ,. ��K" •..''. y,.�w -'''.r.+ 4.. ..ks�,' oaf -t,.a+t i+r ,„ e'.. .3�„'�r`p <br /> SAN JOAQUIN COUNTY <br /> NVIRONMENTAL HEALTH DEPARTMENT 1 <br /> • I <br /> 304 East Weber Avenue,3dFloor, Stockton, CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sj ov.or /g ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> 5 <br /> Facility address: UST# -7 <br /> S �,,�. 1 Sr• Product <br /> Facility Contact: Title: Phone: <br /> 3i P-LA K�__(Z Sio - 4-1,i_ (o114 b <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> 10W-3 TS-►t7UO Pressurized ❑Suction ❑Gravity ❑Mechanical ❑Audible/visual <br /> Inspection type: Violations: <br /> El Routine Monitoring Certification ❑Installation ❑Other: ❑M1-RD ct "`" =W-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATIONS) HSC=California Health&Safety Code;CCR=Califo ta,Code of Regulations V R <br /> V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit too erate <br /> =: '; 2637 Sec cttztt&7it�ttest!, midi - ' <br /> 3 CCR 2711 b & c Current Unified Pro am Consolidated Forms on file with EHD(Facility and tank form <br /> 9. n aFO tter <br /> 5 CCR 2632(c42Q Monitoring&res' nse plan is.cunent.and filed with the local a ency <br /> 6 sl a'' ': 77 <br /> .,.. <br /> 7 CCR 2712 Maintenance&monitoring records M1 <br /> S <br /> 9 HSC 25292.1 UST system is operated to prevent unauthorized release <br /> 10 C 263` 06ft, <br /> - ° gent M77 <br /> �. _:; <br /> 11 CCR 2630 d UST s stem monitoring a ui ment is-RLoerIX located to detect a leak 1 <br /> 12 $C 25291. Ute' inoidt` t is Tonal` M <br /> 13 CCR 2636 1 Continuous monitorin&s tem for u der ,ound pi2ing&UDC is present Mi. <br /> 14 1;. ctlrttairurt ts, tict tl!' h; <br /> 15, �C 25291 a 2 Second containment for UST is tight <br /> 006 N 1 Ase1 inrse=. idar a ct 11 tion. <br /> 1.7 ' HSC 25291 Line leak detectors are installed Ml <br /> 18; :26355:(b)(1) S i11 cantaner f <br /> 191:, CCR 2635(b)(2) Overfill prevention system M2 <br /> 120 2636(4} Conventional suction shall have continuous monitoring&2°containment <br /> 14SC 25291 (e) Water.in 2°containment analyzed& ly disposed of <br /> R 26517 Rec+itlin of orized'releases 1 <br /> 23 CCR 2715 Designated Operatofr a Statement from UST owner; (c-e)Monthly inspection; Employee training <br /> 24 ,CCR 2638 a Annuallnontt. ce....__lwatiota <br /> 25 CCR 2638 a Annual line le!� detector test. Ml <br /> arllb. .a„ r3 a k' n r <br /> P1. fe_:. •:. _b .,f, - <br /> 27 CCR 2636 4 Annual line ti tress test i <br /> 2 aillcl 'a telt <br /> 29 CCR 2643 e Biennial tightness test of avi i m re-January 1, 1984 <br /> r <br /> 2643 Toil Citta test ft convetlttanttt777 <br /> =fan ` 1,'198 .. (Mh <br /> 31 HSC 25292.5 Double wall s stem located within 1000'of public well-ELD <br /> 12 R 2661P xtlit to r UST system <br /> 33 HSC 25286 a Permit to alter monitoring s stem <br /> 1, 25298 li t t*! ' ly clow UST.s. tem <br /> 35 H 25298 c Permit to close UST system <br /> r " 25299 a 9 Disablin leak detection'dt'vices <br /> 7 25298 a Illegal abandonment of UST system <br /> HR INSP CTOR: PHONE: UIC <br /> Septic system: <br /> [� ❑Serves>_20 people/day <br /> D BY: TITLE: ❑Receives other than sanitary waste <br /> 4 T Other disposal methods: <br /> ❑Dry wells/French Drains <br /> FHD 23-02-002 <br />