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R SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMEAR <br /> 304 East Weber Avenue,3`4 Floor,Stockton,CA 95202-2708 <br /> Telephone:(209):468-3420 Fax:(209)468-3433,Web:www.sjgov.org/ehd <br /> UNDERGROUND STORAGE( TANK ST PROGRAM INSPECTION REPORT <br /> Facility name:. Designated Operator:P Inspection Date: <br /> LODt !A Lp gh <br /> �i <br /> Facility address: >15T <br /> 1.. <br /> ' Facility Contact: Title Phones <br /> Product <br /> �f SSP ' <br /> Monitoring Panel: I Piping system: verfill preventione <br /> �t► ❑Pressurized Suction ❑ <br /> GravityMechanical 11Audible/visiaal <br /> Inspection type: Violations: <br /> I A�ROUtine Monitorin Certification ❑Installation ❑Other:. ❑Ml-ions: t ❑M2- v <br /> _ RPre 0 ABoth <br /> # Code Section VIOLATION(S) HSC=California Health&.Safety.Code;CCR=California Cpde of Regulations V=Violation;RV=Re eat Violation <br /> 1 HSC 25284 Permit tooperate <br /> 2 CR 2637 brill ' contartme>rt test 4ir�iied, <br /> a <br /> 3 CCR 2711 & c Current Unified Program Consolidated Forms on file with EHD Facili and tank form <br /> 4 HSC 292 ett�or.if': rtl.`. lb's""ilsih anise CFb"le(ter <br /> 5 CCR 2632(c)(2)(1)). Momtonn &response plan is current and filed with the local agency <br /> 77=6 + C7 l. otttxn ttse :lzts oTasate <br /> 7 CCR 2712 Maintena_pWnce&monitonn records <br /> 8 iCl X43 alto. . ;ttfsuctla l ui 1 <br /> k,!1984 <br /> 9 HSC 25292.1 UST s stem is o erated to prevent unauthorized release <br /> ~l�y?ltl�tk �ttllfS. t'�setct' <br /> 11 CCR 2630 d UST s stem momtorm a ui ment is ro erl located to detect a leak Ml <br /> 13 CCR 26 irnoti�tott ttI sirs i;l, " i�nai , <br /> 36 1 Continuous momtonn s stem for underground piping&UDC is resent <br /> - Ml <br /> 15 HSC 25291 a 2 Second containment for UST is tight <br /> 6 .. s. ,,. �. t loiidolettonsuiv77 <br /> 17 HSC 25291 Line leak detectors are installed <br /> .. 1 <br /> 19 CCR 2635 2 Overfill revention s stem <br /> s ► � �ftita w tr <br /> 10 <br /> l�l �onttituous triontann 8c 2. c�ntiittxirit7777 <br /> M2 <br /> 21 HSC 25291 e <br /> ffVV,/('"y1py � ) Water.in 2°containment dial ed& ro rl dts osed of <br /> 23 CCR 2715 Desi ated erator a Statement from UST owner, c-e Monthl m ection, Em to ee trainm , <br /> 25 CCR 2638 a Annual line leak detector test <br /> uta <br /> 27 CCR 2636 4 Annual fine ti tness test '' - <br /> '�� <br /> 29 CCR 2643 a Biennial ti tress tet of avi i m to January 1, 1984 V <br /> 3Q G..:.� 3 ittt��.I `stirfir. }� <br /> 31 HSC 25292.5 Double walls stem located within 1000'of ubhc well-ELD - <br /> �3� � ,. <br /> 33 HSC 25286 a Permit to`alter monitorin s stemys " <br /> 4 C 28 <br /> 35 HSC 25298 c Permit to close UST system <br /> a 59 a lsabltn ';ek dettio <br /> eld <br /> 37 HSC 25298 a illegal abandonment of UST s tem <br /> END INSPECTOR: PHONE: <br /> UIC <br /> 4 6�- ;4`$ t Septic system: <br /> 77771 <br /> RECEIVED ❑Serves>10 people/day <br /> TITLE: ❑Receives other than sanitary waste <br /> t Other disposal methodr <br /> ❑ wells/French Drains <br /> F14T)23-02-002 <br />