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. SAN JOAQUIN COUNTY 4 <br /> — - ENVIRONMENTAL HEALTH DEPARTMENT = <br /> 304 East Weber Avenue,3`a Floor,Stockton,CA 95202-2708 ti <br /> - Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.or <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator; Inspection Date: <br /> Facility address: UST# <br /> Product <br /> Facility Contact: tl Phone: �Q <br /> Monitoring Panel: Piping system- Y� Overfill prevention: <br /> { / <br /> 1 127`) ❑Pressurized ❑Suction ❑Gravity ❑Mechanical ❑Audible/visual <br /> Inspection type: Violations: <br /> ❑Routine ❑Monitoring Certification ❑Installation ❑Other: ❑Ml-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section <br /> V=Violation;RV=Re eat Violation V <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 <br /> 5 CCR 2632 c)2 D Monitoring&response plan is current and filed with the local agency <br /> 6 C 2712(i) Monitoring&response plan is onsite <br /> 7 CCR 2712 Maintenance&monitoring records (Mi) <br /> 8 CCR 2643 1.Didly monitoring ofsuctionpiping(pre-January,1, 1984 <br /> 9 HSC 25292.1 UST system iso erated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitorings stem is present (MI) <br /> 11 CCR 2630 d UST system monitoring equipment is properly located to detect a leak (MI) <br /> 12 HSC 25,291 (b) USTsystem monitoring equipment isoperational M2) <br /> 13 CCR 2636 1 Continuous monitoring system for underground piting&UDC is Ugent M1 <br /> 14 CCR 26,3 f " ) `. Primaq containment is product tight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> It CCR 2636 c 1 ' All releases in second in flow to a collection SUMP <br /> 17 HSC 25291 Line leak detector(s)are installed M1) <br /> I8CCR 2635 (1) Sill container M2 . <br /> 19 CCR 2635(b)(2) Overfill prevention system M2 <br /> ILL CCR 2636(a) Conventional suction piping shall have continuous'monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 2" CCR 2650 Recordin r poriirt of authorized releases M;• <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly inspection;(9 Employee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test MI" <br /> 26 <br /> HSC-15284.1 AnnualSpill containmertt tesft <br /> 27 CCR 2636 (4) Annual line tightness test I <br /> 48 CCR 2661(f) R it for tank/piping has had titress test <br /> 29 CCR 2643 e) Biennial tightness test of gravity piping( re-Januar 1, 1984 <br /> 30 CCR 2643(d) Triennial line test for conventional suction piping(pv� "1,1984, SMI <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to system <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 34 HSC 25298 Permit to temporarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299(a)(9) Disabling leak detection devices <br /> 37 HSC 25298(a) Illegal abandonment of UST system <br /> 38' Other: ` <br /> EHD INSPECTOR: PHONE: UIC <br /> I 1a} Sematic system: <br /> El Serves>_20 people/day <br /> 7 <br /> RECEIV / ,� TITLE: a Receives other than sanitary waste <br /> Other disposal methods: <br /> *,T' Dry wells/French Drains <br /> EHD 23-02-002 <br />