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SAN JOAQUIN COUNTY <br /> OVIRCINMENTAL HEALTH DEPARTMENT304 EastWeber Avenue,3rd Floor, Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sigov.org/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Dat/e: <br /> CJ i�-�-;`7 � �' �l3 STS� j �� •-et{�G"J <br /> Facility address: UST# <br /> '5. Product 1 C <br /> Facility Contact: Title: Phone: <br /> �M/onitoring Panel: P?' ing system: Overfill prevention: <br /> V (lam- 7�, �L`�Pressurized 11Suction ElGravity Mechanical ❑Audible/visual <br /> Inspection type:30 iolations: <br /> Routine Monitoring Certification ❑Installation ❑Other: ❑M1-RDetect M2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATIONS) HSC=California Health&Safety Code;CCR=California Code of Regulations V R V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit tooperate <br /> 2i 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 CCR 2712(i) Monitoring&response plan 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 resent (Mi) <br /> 11 CCR 2630 d UST system monitoring equipment is properly located to detect a leak Ml <br /> 12 HSC 25291 b 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 Primary containment is product tight <br /> 15 HSC 25291 (a)(2)4 Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in secondary piping flow to a collection sum <br /> 17 HSC 25291 ( Line leak detector(s)are installed (Mi) <br /> 18 CCR 2635(b)(1) Spill container (M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system A (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 Recording/reporting of unauthorized releases Ml <br /> 23 CCR 2715 Desi ated erator:(a)Statement from UST owner; (c-e)Monthly inspection;(f)Employee trainin <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (Ml) <br /> 26 1 HSC 25284.2 Annual spill containment testing <br /> 27 CCR 2636 4) Annual line tightness test M1 <br /> 28 CCR 2661 ( Repair for tank/piping has had ti tress test (M2) <br /> 29 CCR 2643 e Biennial tightness test of gravity piping( re-Janus 1, 1984 <br /> 30 CCR 2643(d) Triennial line test for conventional suction piping(pre-January1, 1984 (Mi) <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 ) 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 /> Vi,o-4 Septic system: <br /> ❑Serves>_20 people/day <br /> RECEIVED BY: TITLE: ❑Receives other than sanitary waste <br /> Other disposal methods: <br /> ❑Dry wells/French Drains <br /> EHD 23-02-002 <br />