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SAN JOAQUIN COUNTY <br /> 304 AVIRONMENTAL HEALTH DEPARTMENT <br /> asWeber Avenue,3`a Floor,Stockton,CA 95202- 708 <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 Date: <br /> FftJ Eud 61t s <br /> Facility address: UST# r� <br /> Product <br /> Facility Contact: TTitl'e:- F Phone: <br /> [MGonitorintPanel: IFTing system: Overfill prevention: <br /> ressurized ❑Suction ❑Gravity NiMechanical ❑Audible/visual <br /> Inspection type: solations: <br /> Routine ❑Monitoring Certification ❑Installation ❑Other: ❑MI-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATION(S) 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 /> 2CCR 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 /> 4G 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 1 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632 c)(2) UST monitoring system is present (Ml) <br /> 1 I CCR 2630 d UST system monitoring equipment is properly located to detect a leak Ml <br /> 12 HSC 25291 UST system monitoring equipment isoperational M2 <br /> 13 CCR 2636 1) Continuous monitoring system for underground piping&UDC is present (MI) <br /> 14 CCR 2631 a Primary containment is product tight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is ti ht <br /> 16 CCR 2636(c)(1) All releases in secondary pipingflow to a collection sum <br /> 17 HSC 25291 ( Line leak detectors are installed (Mi) <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&2°containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 1 CCR 2650 Recording/reporting'ofunauthorized releases Mi <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST own!!((c-e9N4onthly ins ectio ;(f) m loyee training <br /> 24 CCR 2638 a Annual monitoring certification <br /> 25 CCR 2638 a) Annual line leak detector test Ml <br /> 26 HSC 25284.2 Annual spill containment testing <br /> 27 CCR 2636 (4) Annual line tightness test (Mi) <br /> 28 CCR 2661( Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643 e 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 (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 HSC 25299(a)(9) Disabling leak detection devices <br /> 37 HSC 25298 a) Illegal abandonment of UST system <br /> 38 Other: <br /> EH NSPEC OR: PHONE: UIC <br /> �4c, � P (J Septic system: <br /> o _! _Serves>_20 p <br /> RE EIVED BY: TITLE: ❑Receive than sanitary waste <br /> Otherl methods: <br /> L]Dry wewe lls/French Drains <br /> F,HD 23-02-002 <br />