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SAN JOAQUIN COUNTY <br /> OENVIRONMENTAL HEALTH DEPARTMEN <br /> 304 East Weber Avenue,3rd Floor, Stockton,CA 952U" -2708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.orjz/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility-name: C Designated Operator: Inspection Date: <br /> Itl ►°�A <br /> Facility address: UST# <br /> r <br /> Product <br /> Facility Contact: Title: Phone: (W) <br /> cot')Of 15 Wl cTP <br /> 1� 9 i?€M 4-74- L2 <br /> Monitoring Panel: gsystem: Overfill prevention: <br /> T( 3 ssurized ❑Suction ❑Gravity ❑Mechanical 'Audible/visual <br /> 7IInss ction type: ! Violations: <br /> 7.Ins <br /> 'Monitoring Certification ❑Installation ❑Other: ❑M1-RDetect ❑M2-RPrev ❑M-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 /> 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 /> 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 MI <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 is operational 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) 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 (0 Line leak detectors are installed MI <br /> 18 CCR2635(b)(1) Sill container (M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system (M2 <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&21 containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Recordin eporting of unauthorized releases Mi <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly inspection; Employee training <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 Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test Ml <br /> 28 CCR 2661 (f) Repair for tank/ iping has had tightness test M2 <br /> 29 CCR 2643 e Biennial ti fitness test of gravity pipingre-Januar 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 1 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 1 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> (o 5(3 q 3cl Septic system: <br /> ❑Serves>_20 people/day <br /> REC E�D BY TITLE: ❑Receives other than sanitary waste <br /> JJ� Other disposal methods:wells/French Drains <br /> F,HD 23-02-002 <br />