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SAN JOAQUIN COUNTY <br /> ONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3`d Floor, Stockton,CA 95202-27 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.or /g ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> ,gAw')t- o f "'T L N 0 R AAP to H1'TE 2 z/U6 <br /> Facility address: UST#F <br /> 2. <br /> L-1 E1-0Product <br /> Facility Contact: Title: Phone: <br /> N otew A) V3 tl1l�- c,G P/LG" 7c�-Nf -'Z-0eA) 271�- <br /> Monitoring Panel: i iq�systerpuM��•rrm�. Overfill prevention: <br /> TL <br /> S 35� ressunzed Suction 11 Gravity ❑Mechanical C)�dible/visual <br /> 7ection type: / Violations: <br /> Routine VNlonitoring Certification ❑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=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 Ml <br /> 8 CCR 2643_(d) Daily monitoring of suction p 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 -resent Mi <br /> 11 CCR 2630 d UST system monitoring equipment is properly located to detect a leak Ml <br /> 12 HSC 25291 UST system monitoring equipment is operational M2) <br /> 13 CCR 2636 I 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 Line leak detectors are installed Ml <br /> 118 CCR 2635 )(i) Spill container (M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system (M2 <br /> 2D 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 of unauthorized releases Ml <br /> 23 CCR 2715 Desi ated Operator:(a)Statement from UST owner; (c-e)Monthly inspection;(f)Employee 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 Annuals ill containment testing <br /> 27 CCR 2636 (4) Annual line tightness test Ml <br /> 28 1 CCR 2661( Repair for tank/piping has had tightness test (M2 <br /> 29 CCR 2643 e Biennial tightness test of gravity pipingre-Januar 1, 1984 <br /> 30 CCR 2643(d) Triennial linetestfor conventional suction piping( re-Jams 1, 1984) (Ml <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 1 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 /> EHD INSPECTOR: PHONE:" UIC <br /> A�wnj/ C7 Septic system: <br /> 1 t� v C'__ Serves>_20 people/day <br /> REC INE BY: TITLE: C Receives other than sanitary waste <br /> G1�J�j� ��1_✓1�� Other disposal methods: <br /> �(J� ❑Dry wells/French Drains <br /> F.HD 23-02-002 <br />