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SAN JOAQUIN COUNTY <br />SkVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3d Floor, Stockton, CA 95202- 708 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility name: <br />Code Section <br />Designated Operator: <br />V R <br />V <br />Inspection Date: <br />N'A4 fta� fr.& <br />Permit tooperate <br />2 <br />11/1, <br />i 10�f <br />lu <br />3 <br />CCR 2711 (b) & (c) <br />Current Unified Pro am Consolidated Forms on file with EHD Facility and tank form) <br />Facility dd4ess: <br />4 <br />UST # A <br />Certification of financial responsibility and CFO letter <br />--7 <br />- <br />eA�Product <br />CCR 2632 (c)(2)(D) <br />MonitorinE & response plan is current and filed with the local aEencX <br />6 <br />Facilit Contact: Title: <br />Phone: <br />7 <br />CCR 2712 (b) <br />&IMd <br />(Mi) <br />8 <br />CCR 2643 (d) <br />Daily monitorinS of suction piping (pre-Janun, 1, 1984) <br />9 <br />HSC 25292.1 <br />UST system isoperated to revent unauthorized release <br />'to g Panel: <br />A fir <br />UST monitoring system is present <br />- ------ <br />Overfill prevention: <br />11 <br />CCR 2630 (d) <br />(i/ <br />Pressurized 11 Suction <br />11 Gravity <br />11 Mechanical <br />UST system monitoring equipment is operational <br />(M2) <br />Inspectibn type: <br />CCR 2636 (f)(1) <br />Violations: <br />(l <br />[I Routine [I Monitoring Certification Installation <br />11 Other: <br />El M I -RDetect <br />0 M2-RPrev 11 M-3 Both <br />1. <br /># <br />Code Section <br />VIOLATION(S) HSC=Califomia Health & Safety Code; CCR=Califomia Code of Regulations <br />V=Violation; RV=Repeat Violation <br />V R <br />V <br />I <br />HSC 25284 <br />Permit tooperate <br />2 <br />CCR 2637 <br />Second)erformed <br />3 <br />CCR 2711 (b) & (c) <br />Current Unified Pro am Consolidated Forms on file with EHD Facility and tank form) <br />4 <br />HSC 25292.2 <br />Certification of financial responsibility and CFO letter <br />5 <br />CCR 2632 (c)(2)(D) <br />MonitorinE & response plan is current and filed with the local aEencX <br />6 <br />CCR 2712 (i) <br />Monitorin & res onse plan is onsite <br />7 <br />CCR 2712 (b) <br />Maintenance & monitoring records <br />(Mi) <br />8 <br />CCR 2643 (d) <br />Daily monitorinS of suction piping (pre-Janun, 1, 1984) <br />9 <br />HSC 25292.1 <br />UST system isoperated to revent unauthorized release <br />10 <br />CCR 2632 (c)(2) <br />UST monitoring system is present <br />(M1 <br />11 <br />CCR 2630 (d) <br />UST system monitoring equipment is properly located to detect a leak <br />(MI) <br />12 <br />HSC 25291 <br />UST system monitoring equipment is operational <br />(M2) <br />13 <br />CCR 2636 (f)(1) <br />s stem for under round piping & UDC is present <br />(l <br />14 <br />CCR 2631 (a) <br />_ContinuouL22ait2rin <br />Primary containment is product tight <br />15 <br />HSC 25291 (a)(2) <br />Secondary containment for UST is tight <br />16 <br />CCR 2636 (c)(1) <br />All releases in second a piping flow to a collection sump <br />17 <br />HSC 25291 (f) <br />Line leak detector(s) are installed <br />(Mi) <br />18 <br />CCR 2635 (b)(1) <br />Spill container <br />(M2) <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system <br />(M2) <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 2' containment <br />21 <br />HSC 25291 (e) <br />Water in 2' containment analyzed & properly disposed of <br />22 <br />CCR 2650 <br />Recording/reporting of unauthorized releases <br />(Mi) <br />23 <br />CCR 2715 <br />Designated 02erator: (a) Statement from UST owner; (c -e) Monthly ins2ection; Em2loyee training <br />24 <br />CCR 2638 (a) <br />Annual monitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test <br />(MI) <br />26 <br />HSC 25284.2 <br />Annual spill containment testing <br />27 <br />CCR 2636 (f)(4) <br />Annual line tiElitness test <br />(MI) <br />28 <br />CCR 2661 (f) <br />Repair for tank/piping has had titress test <br />(M2) <br />29 <br />CCR 2643 (e) <br />Biennial tightness test of Eavity piping (pre -January 1, 1984) <br />30 <br />CCR 2643 (d <br />Triennial line test for conventional suction piping (pre-Janu1, 1984 <br />(Mi) <br />31 <br />HSC 25292.5 <br />Double wall sxstem located within 1000' of Eublic well-ELD <br />32 <br />CCR 2661 <br />Permit to repair UST system <br />33 <br />HSC 25286 (a) <br />Permit to alter monitoring system <br />34 <br />HSC 25298 (b) <br />Permit to temporarily close UST system <br />35 <br />HSC 25298 (c) <br />Permit to close UST system <br />36 <br />HSC 25299 (a)(9) <br />Disabling leak detection devices <br />37 <br />HSC 25298 (a) <br />Illegal abandonment of UST system <br />38 <br />Other: <br />EH INSIECTOR: <br />R9CEIV <br />PHONE: <br />TITLE: <br />UIC <br />Sepi system:, c system: <br />Serves �!20 people/day <br />Ll Receives other than sanitary waste <br />Other disposal methods: <br />_5jrDry wells/French Drains <br />FHT) 21-02-002 <br />