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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3d Floor, Stockton,CA 9520 1 08 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.orgLehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> A/1 76 AUIN l"CO <br /> /0//6/07 <br /> Facility address: UST# <br /> Product V7 <br /> Facility Contact: Title: Phone: <br /> QAG k1ulfs1w <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> TLS I<V P(Pressurized 11 Suction [I Gravit Clechanical 11 Audible/visual <br /> Inspection type: Violations: <br /> 5/Routine El Monitoring Certification 11 Installation 11 Other: 0 M I-RDetect 11 M2-RPrev 0 M-3 Both <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section V=Violation;RV=Re2eat Violation V <br /> I HSC 25284 Permit too2erate <br /> 2 CCR 2637 Second M containment test 2S!formed <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 Mency ✓ <br /> 6 CCR 2712(i) Monitorin�&response plan is onsite <br /> 7 CCR 2712(b) Maintenance&monitoring records (Mi <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 moniiorin system is present (Mi) <br /> I I CCR 2630 d UST s <br /> ystem monitoring equipment is properly located to detect a leak (Mi) <br /> 12 HSC 25291 (b) UST system monito ing equipment isoperational (M2) <br /> 13 CCR 2636(f)(1) -Continuous monitoring system for underground piping&UDC is present (Mi) <br /> 118" CCR 2631 (a) Primary containment is product tight F <br /> 1 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 2636 1!�(I) All releases in secondary piping flow to a collection sump <br /> HSC 25291 (f) Line leak detector(s)are installed (MI) <br /> 1 <br /> CCR Spill container (M21 <br /> 19 CCR 2635(b)(2) Overfill prevention system (M2) <br /> 20 CCR 2636(a) Conventional suction iping shall have continuous monitoring&21 containment <br /> 21 HSC 25291 (e) Water in 2'containment analyzed&properly disposed of <br /> 22 CCR 2650 Recordin reporting of unauthorized releases (Mi) <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly ins2ection; ETRloyee training <br /> 24 CCR 263$(a) Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (Mi) <br /> ,26 _HSC 252841 Annual spill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test (Mi) <br /> 128 CCR 2661(f) Repair for tank/piping has had titness test (M2) <br /> 29 CCR 2643(e) Biennial tightness test of ffavity piping(pre-January 1, 1984) <br /> 30 CCR 2643(d) Triennial line test for conventional suction piping(pre-JanuaTy 11984 (Mij <br /> 31 HSC 25292.5 Double wall system located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to re air UST system ✓ <br /> 33 HSC 25286(a) Permit to alter monitorinsystem <br /> 134 HSC 25298Permit to temporarily close UST system <br /> 35 HSC 25298(c) Permit to close UST system <br /> 136 1 HSC 25299(a)(91 Disabling leak detection devices <br /> 37 HSC 25298(a) _Elgal abandonment of UST system <br /> _8Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> k <br /> A A_Ja4A Septic system: <br /> 0 Serves�:20 people/day <br /> RECEIVED BY: TITLE: 0 Receives other than sanitary waste <br /> 10Other disposal methods: <br /> 0 22 wells/French Drains <br /> F14D 23-02-002 <br />