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8''oZ <br />PUBLEALTH SERVICES SAN JOAQUINi1UNTY DATE -i •PR# <br />ENVIRONMENTAL -HEALTH DIVISION PAGE <br />304 E. Weber Ave., Third Floor, Stockton, CA 95202 <br />(209) 468-3420 <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility Name,�"p5 CtiWJ 1 5no;�Facility Address �tO WAS Jak .NC NIC <br />Facilty Contact loe W r TitlePhone # Y ( `�' 81 S <br />u i S"'"— <br />UST# \ Product Zka& UST# Product UST#_Product UST# Product <br />Overfill Prevention: ❑ AudibleNisual 12(mechanical C. f (kcic <br />9 �.rL Monitoring Panel: C W <br />Piping System: ❑ Gravity ❑ Pressure ❑ Suction Violations: Minor ❑ Major <br />Automatic Pump Shut Down Satisfies CCR 2636 DYesyrNo Dispenser Pan: ❑ Yes ❑ No <br />IV Ar <br />INSPECTION TYPE: 16koutine`�Oonitoring Certification ❑Complaint ❑Install ❑Removal ❑Repair/Upgrade <br />COMPANY NAME:S 6A(k_. _ TECHNICIAN NAME:kALPHONE: — .3 3--� <br />V IULH I IUNkQ) <br />UNITHINST/INSP (rev 1/15/02) <br />The above facility is not in compliance with the following <br />section(s) of Health & Safety Code (HSC) and/or <br />California Code of Regulations <br />(CCR): <br />1 <br />HSC 25284 <br />Permit to operate <br />20 <br />410k:eR 2712 (b) <br />Maintenance & monitoring <br />2 <br />CCR 2637 <br />Secondary cont testing (6 <br />month/36 month) <br />21 <br />CCR 2636 (f)(4) <br />records <br />Annual line tightness test <br />3 <br />CCR 2711(b) & (c) <br />Current State Forms A & B <br />22 <br />CCR 2630 (d) <br />Annual line leak detector test <br />4 --~HSC 25292.2 <br />Certification of financial <br />23 <br />CCR 2630 (d) <br />Annual monitoring certification <br />responsibility and letter from <br />24 <br />CCR 2643 (d) <br />Daily monitoring of suction <br />chief financial officer <br />piping that is not continuously <br />5 <br />CCR 2630 (d) <br />Continuous monitoring system <br />for UST system <br />25 <br />CCR 2643 (d) <br />monitored <br />Triennial tightness test of <br />6 <br />CCR 2636 (c)(1) <br />All releases in secondary piping <br />suction piping that is not <br />flow to a collection sump <br />continuously monitored <br />7 <br />HSC 25291 (e) <br />Water in secondary (20) cont <br />26 <br />CCR 2643 (e) <br />Biennial tightness test of gravity <br />piping that is not continuously <br />8 <br />HSC 25291 (f) <br />Automatic line leak detector(s) <br />monitored <br />9 <br />CCR 2636 (f)(1) <br />Continuous monitoring system <br />for underground piping <br />27 <br />CCR 2662 <br />Upgrade requirements for UST <br />10 <br />CCR 2632 (c)(2) <br />Continuous monitoring system <br />28 <br />CCR 2661 <br />system <br />Permit to repair UST system <br />11 <br />HSC 25291(a)(2) <br />for UST <br />Secondary containment for <br />29 <br />HSC 25286 (a) <br />Permit to alter monitoring <br />12 <br />CCR 2636 (f)(1) <br />UST is tight <br />Continuous monitoring system <br />30 <br />HSC 25298 (a) <br />system <br />Illegal abandonment of UST <br />13 <br />CCR 2635 (b)(1) <br />for dispenser system <br />Spill container <br />31 <br />HSC 25298 (b) <br />system <br />Permit to temporarily close US-l­ <br />ST14 <br />14 <br />15 <br />CCR 2635 (b)(2) <br />CCR 2631 (a) <br />Overfill prevention system <br />Primary containment is product- <br />32 <br />HSC 25298 (c) <br />system <br />Permit to close UST system <br />tight <br />33 <br />HSC 25291 (e) <br />Water in 20 cont analyzed and <br />16 <br />HSC 25292.1 <br />UST system is operated to <br />prevent unauthorized release <br />34 <br />CCR 2640 (e) <br />properly disposed of <br />Single wall component within <br />17 <br />CCR 2650 <br />Recording/reporting <br />unauthorized release <br />35 <br />1000' of Public Well, no ELD <br />CCR 2635(a)(2)(A) Cathodic protection testing <br />18 <br />CCR 2632 (d) <br />Monitoring & response plan <br />36 <br />H&SC 25299(a)(9) Disabling leak detect. devices <br />19 <br />CCR 2712 (i) <br />Monitoring & response plan is <br />37 <br />Violation(s) not listed above <br />on site <br />18 y 7 <br />EHD INSPECTOR: <br />A <br />PHONE: <br />RECEIVED BY: <br />TITLE: <br />PHONE: <br />UNITHINST/INSP (rev 1/15/02) <br />