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SAN JOAQUIN COUNTY <br /> L'.11VIRONMENTAL HEALTi-i DEPARTMEN-f <br /> 600 East Main Street, Stockton, California 96202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.>jgovvoor_g/ehd <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: I Inspection <br /> i Dato: <br /> �,A 1 <br /> 010 <br /> Facility address: USTO <br /> Product <br /> Facillty Contact: Title: Phone: <br /> H., <br /> ctnitoring Panel: Piping system: Overfill prevention: <br /> �l l/•, ±,?:� S ----- Pressurized µ11 Suction11 Mechanical .1.4"Audible/visuad <br /> Inspection type: Violations: <br /> utine &MonitorinC Certification El Installation 13 Other: 0 M I-RDetect n M2-RPrev D M-3 Boih <br /> VIOLATION(S) HSC=California Health IR <br /> Safety Code;CCR=California Code of Regulations V <br /> N. I <br /> ft [:C7ode Section on;RV=Repeat Violation V <br /> V=Violati <br /> 1 HSC 25284 Permit jooperate <br /> 2 CCR 2637 Secongqaconta:inm tit test erformed <br /> 3 CCR 2711 (qAU c Current Unified Program Consolidated Forms on file with EHD(Facility and tank form) <br /> 4 HSC 26292.2 _ Certification of financial responsibility and CFO letter <br /> 5 CCR 2632.(b Monitoring Program„SM &Response Plan)is current and approved by the local agency. <br /> 6 CCR 2712 Q) Monitoring plan is onsite. <br /> 7 CCR 2712 (b) Maintenance&monitoring records Ml) <br /> 8 CCR 2643(d) Daily monitorilra_21'suction piping(pre-January, 1,1984) <br /> —9- HSC 25292.1 UST stem is <br /> operated to prevent unauthorized release <br /> 10 CCR 2632(c 2) UST monitoring system is present (MI) <br /> 11 CCR 2630 d) UST system monitoring equipment is properly-located to detect a leak MiL <br /> 12 T2-9j (b) UST system monitoring equi ment is operational <br /> 13 CCR 2636(W) Continuous monitoring system for underground i Ing_&UDC is present (MI) <br /> 14 CCR 2631 (a) Primary containment is product tight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in seconga i in flow to a collection sump <br /> 17 HSC 25291 Line leak detectors <br /> are installed <br /> 18 CCR 2635 b ) Spill container JM2) <br /> 19 CCR 2635(bL2) Overfill prevention system 0 co (M2) <br /> 20 CCR 2636(a) Conventional suction p1pngshal I have c6ntinuous monitoring&2 ritainment <br /> 21 HSC 25291 (e) Water in 21,containment analyzed&prpperly disposed of <br /> -2�2—-CCR 2660 Recordin /reporti2g of unauthorized releases (MI) <br /> 2-3 CCR 2716 Designated.Operator: a)Statement from UST owner: (c-e)Monthly inspection, Employee training <br /> 24 CCR 2638(a) Annual monitori�rtiflcat ion <br /> 25 CCR 2638(a) Annual line leak detector test (MI) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 OCR 2.636(D(4) Annual line tightness test <br /> 28 CCR 2661 (f) Rep <br /> air for tank!piping.has had tightness test (M2) <br /> 29 CCR 2643(e) s inRiLre-January 1, 1984) <br /> Biennial test of gravity I _ y I <br /> 30 CCR 2643 Triennial line test for conventional suction piping(eLe�JaqLi2y 1984.) (MI) <br /> 31 IASO 25292.5 Double wall system located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286(a) Permit to alter monitorinq system <br /> 34 HSC 26298(b Permit to temporarilyclose UST systern <br /> 39-- HSC 26298 Lc) Permit to close UST astern <br /> 36 —HSC 2-5299 Disabling leak detection devices <br /> -37— HSC 25298(a) Illegal abandonment oLUST s stem_ <br /> 38 Other: <br /> 4HP INNP70f 9—R.7. PHONE: UIC <br /> 9�eticsyst, ern,' <br /> V <br /> I I Serves�?.20 people/day <br /> 'RECEIVED BY: TII'LE: 1.1 Receives other than sanitary waste <br /> mheLtisposal methods: <br /> da y <br /> 0 D wells/Frencli Drains <br /> 171,11)23.02.002 REV 8/08 <br /> C-- 01 - CIO M-1 <br />