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• SAN JOAQUIN COUNTY <br /> WIRONMENTAL HEALTH DEPARTMENT <br /> 30 <br /> • 4 East Weber-Avenue 3rd Floor St6ckton,CA'95202 3708 <br /> Telephone.(209)468=3420 Fax4(209)468-3433 Web:Www.sjgoy.org/e <br /> UNDERGROUND STORAGE TANK ST PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> 1/ <br /> Facility address: t UST# <br /> `ie-0! E. .L,r,,C l(ijF-t�? /, U C f�T c. �6 (L 71)N Product E`Gil` <br /> Facility Contact: Title: Phones <br /> t <br /> Monitoring Panel: <br /> JrVZn'jzedr <br /> te <br /> Overf if i revention: <br /> Ef1A!P1&6 <br /> fi <br /> ❑Mechanical W udibWvisual <br /> Inspection type: Violations: <br /> F'Routine ❑Monitoring Certification El Installation ❑Other: ❑MI-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=Repeat Violation <br /> 1 HSC 25284 Permit to operate <br /> 2: GClt2 37' eonwomim test''erfom od <br /> 3 CCR 2711 L& c Current Unified Progm Consolidated Forms on file with EHD(Facility and tank form) <br /> 4 j HSC 25292:2 Cern tcntioai o financial onsibil ' at1t1 CFO letter <br /> 5 CCR 2632 c 2 D Monitorin &res onse plan is current and filed with the local agency <br /> t + R 2?12!10, 1 him ito` & is otaasite <br /> 7 CCR 2712 Maintenance&monitorin records Ml <br /> ` G R 2643 . ? of suction i in �Ire4ariq'' 1, 1 4 <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 1 _ 2602 :c 2 <br /> tl 'tnoni - s etn is .resent , <br /> 11 CCR 2630 d UST system monitoring equipment is pro rly located to detect a leak Ml <br /> 1 HSC 2$2 (, VST syst06;00##qriqg,equjpnentjspional M2 <br /> 13 CCR 2636 1 Continuous inonitoring system for underground piping&UDC is resent- Ml <br /> 1'4 C` :263,11:a i ` nl�t is �fight, <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 17 HSC 25291 Line leak detectors are installe-d Ml <br /> ".. <br /> 19 CCR 2635 2 Overfill 2revention system M2 <br /> .. O It 2636(a) Cottz tit al`suctitttt *A1liveoontinuous monitoring&2'containment <br /> 21 HSC 25291 (e) Water in 20;containment analyzed&g=ly disE2sed of <br /> 'of"utiatttltt� d r + es`' <br /> Mll <br /> 23 CCR 2715 Desi ated rator: a Statement from UST owner; (c-e)Monthly inspection;(f)Em to ee training <br /> 2638 a Ann# �cotion ' <br /> 25 CCR 2638(a) Annual line leak detector test Ml <br /> . , ,;SC.25284..2. Annuals ill containmenttesti 7777 <br /> 27 CCR 2636 41 Annual line tightness test Ml <br /> r <br /> 29 CCR 2643 a Biennial tightness test of Eavity Ripmgre-Jams 1., 1984 <br /> () 613 3, a hest+mr€ tiire►tinaal , itt ary 1,1984 1111 <br /> 31 HSC 25292.5 Double wall system,located within 1000'ofptAblic,well-ELD <br /> "77"15M,2661 . Ettt ' UST system <br /> 33 HSC 25286 a Permit to alter in.onitoring s stem <br /> 34 Ik 25298;,. . . :'' ttti l close UST.systm <br /> 35 HSC 25298 a Permit to close UST system <br /> I4SC 25299(4)(9) 'Disablin .leak Gletebbon devices <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> o-38 Omer: <br /> EHD INSPECTOR: PHONE: <br /> � Serves <br /> _ UIC <br /> S <br /> r , <br /> : } � tic system: <br /> ❑S <br /> erves>_20 people/day <br /> REC E BY: l. 1' l TITLE: 0 Receives other than sanitary waste <br /> Other disposal methods: <br /> ❑Dry wells/French Drains <br /> FHD 23-02-002 <br />