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SAN JOAQUIN COUNTY <br />ONVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-0708 <br />Telephone. (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd <br />UNDERGROUND STORAGE TANK JUSTPROGRAM <br />INSPECTION REPORT <br />Facility name: <br />V RI <br />V <br />Designated Operator: Inspection Date: <br />HSC 25284 <br />Permit to 22erate <br />Facility address: <br />CCR 2637 <br />UST# 7 <br />s7 <br />-7 <br />too Y6 Ic--m &6:r <br />Current Unified Pro ram Consolidated Forms on file with EHD (Facility and tank form) <br />4 <br />-� <br />Certification of financial responsibility and CFO letter <br />Product <br />CCR 2632 (c)Q(D) <br />MonitorinE & res2onse plan is current and filed with the local agency <br />FacilityContact: Title: <br />Phone: <br />CCR 2712' J) <br />MonitorinE & resiLonse plan is onsite <br />6a!a=(iNe 'R*W 0(1-�NjFk <br />CCR 2712 fl?) <br />Maintenance & monitorinE records <br />(Mi) <br />8 <br />Monitoring Panel: <br />Piping system: <br />OveFfill prevention: <br />HSC 25292.1 <br />TKessurized 11 Suction <br />El Gravity <br />E/Mechanical 11 Audible/visual <br />Inspection type: <br />UST monitor' sEtem is"e ent <br />Violations: <br />14outine 04nitoring Certification El Installation <br />El Other: <br />11 MI -RDetect 11 M2-RPrev El M-3 Both <br /># <br />Code Section <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=Califomia Code of Regulations <br />V=Violation; RV=Repeat Violation <br />V RI <br />V <br />I <br />HSC 25284 <br />Permit to 22erate <br />2 <br />CCR 2637 <br />Secondary containment test perf6rmed <br />3 <br />CCR 2711 (b) & (c) <br />Current Unified Pro ram Consolidated Forms on file with EHD (Facility and tank form) <br />4 <br />HSC 25292.2 <br />Certification of financial responsibility and CFO letter <br />5 <br />CCR 2632 (c)Q(D) <br />MonitorinE & res2onse plan is current and filed with the local agency <br />6 <br />CCR 2712' J) <br />MonitorinE & resiLonse plan is onsite <br />7 <br />CCR 2712 fl?) <br />Maintenance & monitorinE records <br />(Mi) <br />8 <br />CCR 2643'(d) <br />Daily monitoring of suctionpiLing KpLe:January, 1, 1984) <br />9 <br />HSC 25292.1 <br />UST system isoperated to revent unauthorized release <br />10 <br />CCR 2632 (c)Q <br />UST monitor' sEtem is"e ent <br />(Mi) <br />11 <br />CCR 2630 (d) <br />UST system monitoring equipment is properly located to detect a leak <br />(MI) <br />12 <br />HSC 25291 <br />UST system monitorina EquippLent is 2perational <br />(M2) <br />13 <br />CCR 2636 (f)(1) <br />Continuous monitorinE system for underground Ri2ing & UDC is present <br />LiL <br />14 <br />CCR 2631 (a) <br />Primary containment is pToduct tight <br />-15 <br />--HSC 25291 (a)(2) <br />Secondary containment for UST is tight <br />16 <br />17 <br />CCR 2636 (c) 1 (1) <br />HSC 25291 (f) <br />All releases in second !a pipiii g.flow to a collection sump <br />Line leak detector(s) are installed <br />(Mi) <br />18' <br />CCR 2635 (b)(1) <br />Spill container <br />(M2) <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system <br />(N12) <br />20 <br />CCR 2636;.(a) <br />Conventional suction piping:shall have continuous monitoring & 21 containment <br />21 <br />HSC 25291 (e) <br />Water in 2' containment analyzed & pro erly disposed of <br />22 <br />CCR 2650 <br />RecordingrEporcin g of unap(hqr*0,,ie16ases <br />Ml <br />23 <br />CCR 2715 <br />Desi&2ated 02erator: (a) Statement from UST owner; (c -e) Monthly ins2ection; ETRloyee trainin� <br />N <br />CCR 2638'i(g <br />Annual monitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test <br />(Mi) <br />26 <br />HSC 25284.2 <br />Annual 2Lill containment testing <br />27 <br />CCR 2636 (DK4 <br />Annual line tightness test <br />28 <br />CCR 2661 (D <br />Repair for !2Lfl�di ing has had tightness test <br />(M2) <br />29 <br />CCR 2643 Ke) <br />Biennial tightness test of gravity piping (pre -January 1, 1984) <br />30 <br />CCR 2643 (d) <br />Triennial line test for conventional suction '2jpLmj (pre -January 1, 1984; <br />(Mi) <br />31 <br />HSC 25292.5 <br />Double wall system located within 1000' of 2ublic well-ELD <br />32 <br />CCR 2661 <br />Permit to repair UST system <br />33 <br />HSC 25286 (a) <br />Permit to alter monitoring system <br />34 <br />HSC 25298 Q?) <br />Permit to temporarily close UST system <br />35 <br />HSC 25298 (c) <br />Permit to close UST system <br />36 <br />HSC 25299 (a)(9) <br />Disabling leak detection devices <br />37 <br />HSC 25298 (a) <br />Illegal abandonment of UST system <br />38 <br />1 Other: <br />EHD INSPECTOR: <br />RECEIVED,BY4,;j�_., <br />PHONE: <br />LM 1 &6J <br />. _ k I TITLE: <br />UIC <br />Septic system: <br />^ Ij Serves �!20 people/day <br />0 Receives other than sanitary waste <br />Other disposal methods: <br />E Dry wells/French Drains <br />EHD 23-02-002 <br />