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SAN JOAQUIN COUNTY <br /> .16 ONVIRONMENTAL HEALTH DEPARTMENT <br /> 1P 304 East Weber Avenue,3d Floor, Stockton,CA 95202-0708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.orgLehd <br /> UNDERGROUND STORAGE TANK UST J PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> C'Wmio <br /> Facility address: USTH <br /> POO " C,-TOC117N Al <br /> I+Y4 wmrizuo -' Product <br /> Facility Contact: Title: Phone: <br /> M 2f%16 <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> A TLs UP YPressurized 11 Suction El Gravity MMechanical [I Audible/visual <br /> Inspection type: Violations: <br /> V'Routine 34onitoring Certification 11 Installation El Other: 11 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 <br /> V=Violation;RV=Repeat Violation <br /> I HSC 25284 Permit too2erate <br /> CCR 2637 Second Tj 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 responsibifity and CFO letter <br /> 5 CCR 2632(c)(2)(D Monitoring&resgonse plan is current and filed with the local Mency <br /> 6 CCR 2712(i) Monitoring&response plan is onsite <br /> 7 CCR 2712(b) Maintenance&monitoring records (Mi) <br /> 8 CCR 2643(d) Daily monitoring of suction piping(pre-Jana'n, 1, 1984) <br /> 9 HSC 25292.1 UST system iso2erated to prevent unauthorized release <br /> 10 1 CCR 2632(c)(2) UST monitoring system is present (Mi) <br /> 11 CCR 2630(d) UST system monitoring equipment is proRerly located to detect a leak (Mi) <br /> 12 HSC 25291 (b) UST sistem monitoring aipment isoperational (M2) <br /> 13 CCR 2636(f)(1) Continuous monitoring system for underEound piping&UDC is present (MI) <br /> 14 CCR 2631 (a) Primary containment is product tight <br /> 15 HSC 25291 (a)(2Second n containment for UST is tight <br /> 16 1 CCR 2636(c)(1) All releases in secondary piping flow to a collection sum2 <br /> 17 HSC 25291 Line leak detector(s)are installed (Mi) <br /> CCR 2635(b)(1) SL111 container (M2) <br /> 19 CCR 2635(b)(2) Overfill 2revention system (M2) <br /> 120 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2'containment <br /> 21 HSC 25291 (e) Water in 2'containment analyzed&pr22erly disposed of <br /> 22 1 CCR 2650 RecordinWrM2run"g of unauthorized releases <br /> (Mi) <br /> 23 CCR 2715 Desig2ated 02erator:(a)Statement from UST owner; (c-e)Monthly ins2ection; Em to training <br /> 24 CCR 2638' Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test <br /> 26 HSC 25284.2 Annual spill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test (Mi) <br /> 28 CCR 2661(f) Repair for tank/piping has had ti tress test (M2) <br /> 29 CCR 2643(e) Biennial tightness test of gravity 2ipinZ(pre-January 1, 1984) <br /> 30 CCR 2643`'`Ld) Triennial line test for conventional suction tjLmg(pre-January 1, 1984) ML <br /> 31 HSC 25292.5 Double wall astem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to r' it UST system <br /> 33 HSC 25286(a) Permit to alter monitoring system <br /> 34 HSC 25298(b) Permit to temporarily close UST s)LsLem <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 /> Septic system: <br /> Serves 2:20 people/day <br /> RE VU BY: TITLE: I]Receives other than sanitary waste <br /> pe Other disposal methods: <br /> Dry wells/French Drains <br /> FHD 23-02-002 <br />