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SAN JOAQUIN COUNTY DATE t-(' - ®J - <br />PR# <br />ENVIRONMENTAL HEALTH DEPARTM NT PAGE <br />304 E. Weber Ave., Third Floor, Stockton, CA 95202 <br />(209) 468-3420 <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility Name Gic�� ` Facility Address <br />Facilty Contact i Ste o 6 c, Title O N49K- Phone # <br />UST# Product'UST# Product UST#Product UST# Product <br />Overfill Prevention: ❑ AudibleNisual kmechanical Monitoring Panel: -,fl 014 JDK <br />Piping System: 0 Gravity ❑ Pressure 14zuction Violations: ❑ MinorMajor <br />Automatic Pump Shut Down Satisfies CCR 2636 (g): 11 Yes No Dispenser Pan: es ❑ No <br />INSPECTION TYPE: <br />COMPANY NAME: <br />Certification ❑Complaint ❑Install ❑Removal []Re <br />pair/Upgrade <br />TECHNICIAN NAME: <br />The above facility is not in compliance with the following section(s) of Health & Safety Code (HSC) and/or <br />California Code of Regulations (CCR): <br />1 HSC 25284 <br />Permit to operate <br />20 <br />CCR 2712 (b) <br />Maintenance & monitoring <br />2 CCR 2637 <br />Secondary cont testing (6 <br />records <br />month/36 month) <br />21_ <br />CCR 2636 (f)(4) <br />Annual line tightness test <br />3 3,Z CCR 2711(b) & (c) Current State Forms A & B <br />22 <br />CCR 2630 (d) <br />Annual line leak detector test <br />4_�„,/_HSC 25292.2 <br />Certification of financial <br />23 CCR 2630 (d) <br />Annual monitoring certification <br />responsibility and letter from <br />24 <br />CCR 2643 (d) <br />Daily monitoring of suction <br />chief financial officer <br />piping that is not continuously <br />5 CCR 2630 (d) <br />Continuous monitoring system <br />monitored <br />for UST system <br />25 <br />CCR 2643 (d) <br />Triennial tightness test of <br />6 CCR 2636 (c)(1) <br />All releases in secondary piping <br />suction piping that is not <br />flow to a collection sump <br />continuously monitored <br />7 HSC 25291 (e) <br />Water in secondary (20) cont <br />26 <br />CCR 2643 (e) <br />Biennial tightness test of gravity <br />8 HSC 25291 (f) <br />Automatic line leak detector(s) <br />piping that is not continuously <br />9 CCR 2636 (f)(1) <br />Continuous monitoring system <br />monitored <br />for underground piping <br />27 <br />CCR 2662 <br />Upgrade requirements for UST <br />10 CCR 2632 (c)(2) <br />Continuous monitoring system <br />system <br />for UST <br />28 <br />CCR 2661 <br />Permit to repair UST system <br />11 HSC 25291(a)(2) <br />Secondary containment for <br />29 <br />HSC 25286 (a) <br />Permit to alter monitoring <br />UST is tight <br />system <br />12 CCR 2636 (f)(1) <br />Continuous monitoring system <br />30 <br />HSC 25298 (a) <br />Illegal abandonment of UST <br />for dispenser system <br />system <br />13 CCR 2635 (b)(1) <br />Spill container <br />31 <br />HSC 25298 (b) <br />Permit to temporarily close US7; <br />14 CCR 2635 (b)(2) <br />Overfill prevention system <br />system <br />15 CCR 2631 (a) <br />Primary containment is product- <br />32 <br />HSC 25298 (c) <br />Permit to close UST system <br />tight <br />33 <br />HSC 25291 (e) <br />Water in 20 cont analyzed and <br />16 HSC 25292.1 <br />UST system is operated to <br />properly disposed of <br />prevent unauthorized release <br />34 <br />CCR 2640 (e) <br />Single wall component within <br />17 CCR 2650 <br />Recording/reporting <br />1000' of Public Well, no ELD <br />unauthorized release <br />35 <br />CCR 2635(a)(2)(A) Cathodic protection testing <br />18 CCR 2632 (d) <br />Monitoring & response plan <br />36 <br />H&SC 25299(a)(9) Disabling leak detect. devices <br />19 CCR 2712 (i) <br />Monitoring & response plan is <br />37 <br />Violation(s) not listed above <br />on site <br />EHD INSPECTOR: <br />M <br />UNITIIUUST/INSP (rev 3/5/02) <br />PHONE: <br />PHONE: 17 <br />