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SAN JOAQUIN COUNTY <br /> last <br /> NVIRONMENTAL HEALTH DEPARTMENT <br /> l 304Weber Avenue, 3`d Floor, Stockton,CA 9520/- 708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sj-_og_v.or <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> W05P1i rt_ 9AA <br /> Facility address: �� UST# <br /> 5t . <br /> �l1!• f �T�" Product � <br /> Facility Contact: Title: Phone: <br /> 4 Fo%, V'OVLJObOtJ OLU101kZ• C-ANK�- <br /> Monitoring Panel: T n i ing system: Overfill prevention: <br /> oressurized ❑Suction ❑Gravity Mechanical ❑Audible/visual <br /> inspection type: Violations: <br /> RoutineMonitoring Certification ElInstallation ElOther: ElMl-RDetect ElM2-RPrev 11M-3 Both <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section V <br /> 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 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 1 CCR 2712(i) -Monitoring&response plan is onsite <br /> 7 CCR 2712 b Maintenance&monitoring 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 c)(2) UST monitoring system is present (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(f)(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) 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 (f) Line leak detectors are installed (Ml) <br /> 18 CCR 2635(b)(1) Spill container (M2 <br /> 19 CCR 2635 b)(2) Overfill prevention system M2 <br /> 20CCR 2636(a) Conventional suction piping shall have continuous monitoring&21 containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases Ml <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly inspection;(f)Employee training <br /> 24 CCR 263$ a Annual monitoring certification <br /> 25 CCR 2638 a) Annual line leak detector test (Mi) <br /> 26 HSC 25284.2 Annuals ill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test Ml <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-Januar 1, 1984 <br /> 30 CCR 2643`4. d Triennial line test for conventional suction piping(pre-January 1, 1984) 1 (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(b) Permit to temporarily close UST system <br /> 35 HSC 25298(c) Permit to close UST system <br /> 36 1 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 /> Septic system: <br /> V�► ( �1 0 Serves>_20 people/day <br /> RECEIV -' TITLE: ❑Receives other than sanitary waste <br /> �/ Other disposal methods: <br /> IVL , 'Lf <br /> l v ✓ �p..., , L1 Dry wells/French Drains <br /> L` , <br /> FHD 23-02-002 <br />