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I(Iry ' <br /> SAN JOAQUIN COUNTY <br /> ONVIRONMENTAL HEALTH DEPARTMENT • <br /> 600 East Main Street, Stockton, California 95202-3029 <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: Inspection <br /> &lel, IkC. M I lGyw► Dt i��t 1 oil <br /> Facility address: fes, c•� L <br /> UST# S q <br /> �� qrD 4 D .��P Product g7 <br /> t-I'�rz- - lr <br /> Facility Contact: Title: Phone: <br /> CNS owN�r2. C�19 X78' g�7 � � � <br /> Monitoring Panel: Piping system: Ovill prevention: <br /> �essurized ElSuction ❑Gravity 5Qechanical ❑Audible/visual <br /> 7Ins ection type: //� Violations: <br /> [ outine Q'Monitoring Certification ❑Installation ❑Other: ❑M1-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC=California Health&Safety Code; CCR=California Code of Regulations V R <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 b Monitoring Program(Monitoring& Res onse Plan is current and approved by the local agency. <br /> X <br /> 6 CCR 2712 i Monitoring Ian is onsite. <br /> 7 CCR 2712 b Maintenance&monitoring records M1 <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 (c)(2) UST monitoring system is present M1) <br /> 11 CCR 2630 d UST system monitoring equipment is properly located to detect a leak M1 <br /> 12 HSC 25291 b UST system monitoring equipment isoperational (M1) <br /> 13 1 CCR 2636 1 Continuous monitoring system for underground piping&UDC is present M1 <br /> 14 1 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 secondary pipingflow to a collection sum <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&20 containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&property disposed of <br /> 22 CCR 2650 Recordingreporting of unauthorized releases M1 <br /> 23 CCR 2715 Designate Operator:/W 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 M1 <br /> 26 HSC 25284.2 Annuals ill containment testin <br /> 27 CCR 2636 4 Annual line tightness test M1) <br /> 28 CCR 2661 Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643 a Biennial tightness test of gravity piping (pre-January 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction piping (pre-January 1, 1984) (M1) <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 /> F34 HSC 25298 b Permit to temporarily close UST system <br /> 35 HSC 25298 c Permit to close UST system <br /> 36 HSC 25299 Disabling leak detection devices <br /> a 9 2 <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38 Other: I _ <br /> EHD INSPECTOR: PHONE: L'IC <br /> /��/ �/ !� 3e <br /> Septic system: <br /> `''r f7 b 5"J F1 Serves>_20 people/day <br /> RECEIVED BY: TITLE: D Receives other than sanitary waste <br /> Other disposal methods: <br /> /Q ❑Dry wells/French Drains <br /> EHD 23-02-002 REV 8/08 <br />