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• SAN JOAQUIN COUNTY • <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3`d Floor,Stockton,CA 95202-2708 <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: Designated Operator: Insp ctio Date: <br /> Conjocv P�`r 1 2 SS Ll �] (fA -vs 4mV47- N �-1 (oS <br /> Facility address: UST# <br /> v Lr <br /> `+ v r "A*p-ofe4p4Product <br /> Facility Contact { itle: 1AAJ�*4G-- Phone: <br /> 823--74 7/,o <br /> onito ing PI Piping system: Overfill prevention: <br /> TL—'0 <br /> V Pressurized ❑Suction ❑Gravity Mechanical ❑Audible/visual <br /> Inspection type: Violations: <br /> )(Routine �Lmonitoring Certification ❑Installation ❑Other: yjvI 1-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATION(S)HSC=California Health&Safety Code;CCR=California Code of Regulations V R V=Violation;RV=Re eat Violation `, <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 1 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 CCR 2712'i Monitoring&response plan is onsite <br /> 7 CCR 2712 b Maintenance&monitorin records Ml <br /> 8 CCR 2643 d Daily monitoring of suction piping(pre-January, 1, 1984 <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632(cX2) UST monitoring system is present MI <br /> I 1 CCR 2630 d UST system monitoring equipment is properly located to detect a leak MI <br /> 12 HSC 25291 UST system monitoring equipment isoperational M2 <br /> 13 CCR 2636 1 Continuous monitoring system for underground piping&UDC is present Ml <br /> 14 CCR 2631 a 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 secondary pipingflow to a collection stun <br /> 17 HSC 25291 Line leak detectors are installed M1 <br /> 18 CCR 2635(b)(1) Spill container M2 <br /> 19 CCR 2635(b)(2) Overfill prevention system M2 <br /> 20 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 /> 22 CCR 2650 Recordingtreporting of unauthorized releases Mi <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly inspection; Employee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638 a Annual line leak detector test Ml <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test MI <br /> 28 CCR 2661 f) Repair for tank/piping has had tightness test M2 <br /> 29 CCR 2643 e Biennial tightness test of gravity pipingre-Janus 1, 1984 <br /> 30 CCR 2643(d) Triennial line test for conventional suction piping(pre-January 1, 1984) (Ml <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 34 HSC 25298(b) 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 INSP TOR: PHONE: UIC <br /> V o �//�� �L 9—�f t*y Q Septic system: <br /> I / �J ` V Serves z20 people/day <br /> RECEIV D BY: _ TITLE: / C Receives other than sanitary waste <br /> Other disposal methods: <br /> 111Dry wells/French Drains <br /> L <br /> EHD 23-02-002 <br />