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08/27/2004 08:51 <br />2094683433 FIFTH FLOOR <br />PAGE 02 <br />SAN JOAQUIN COUNTY <br />i NVIRONMENTAL HEALTH <br />1-1ArE <br />PR# <br />DEPART& <br />04 E. Weber Ave., Third Floor, Stockton, CA 95202 <br />PAGE <br />{209) 468-3420 <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION <br />REPORT <br />Facilit N r� <br />Y a�� UtCS�- _Facility Address <br />Facilty Contact <br />Title Phone # <br />UST# i Product UST#2,ProducfUST# Product, 9 l UST# Product <br />Overfill Prevention: <br />Piping <br />0 Audible/Visual '00echanicel Monitoring Panel: <br />_ <br />�[iS <br />System: ❑ Gravity *Eressure 0 Suction Violations; 0 M1-RDet ❑ M2-Rprev ❑ M3 -Both <br />Automatic Pump Shut Down Satisfies CCR 2636 5): 0 Yes 0 No Designated operator: <br />INSPECTION TYPE: Ooutine []Monitoring Certification omplaint ❑Install ❑Removal ❑Repair/Upgrade <br />COMPANY NAME: <br />t TECHNICIAN NAME; PHONE: <br />VIOLATION(S) <br />The above facility is not in compliance with the following section(s) of Health & Safety Code (HSC) and/or <br />California Code of Regulations (CCR): <br />1 <br />2—CCR <br />HSC 25284 <br />Permit to operate 23 CCR 2643 (d) <br />Daily monitoring of suction <br />2637 <br />Secondary cont. testing <br />piping (pre -1/1/84) , <br />3 <br />CCR 2711(b) & (c) Current State Forms A & S 24 CCR 2636 (a) <br />Conventional suction piping <br />4 <br />HSC 25292.2 <br />Certification of financial <br />shall have continuous <br />5 <br />CCR 2632 (c)(2) <br />responsibility & CFO letter <br />UST monitoring is present (M1) 25 CCR 2643 (e) <br />monitoring & 20 containment <br />Biennial tightness test of grevit, <br />- -, <br />6CCR 2630 (d) <br />UST system monitoring <br />piping..(pre-1/1/84) <br />equipment is properly located to 26 CCR 2643 (d) <br />Triennial line test for <br />7 <br />CCR 2637(b) <br />detect a leak (MI) <br />UST system monitoring <br />conventional suction (pre - <br />1/1184) (M1) <br />8 <br />CCR 2636 (f)(1) <br />equipment is operational (M1) 27 CCR 2661 <br />Continuous monitoring system 2$ HSC 25286 (a) <br />Permit to repair UST system <br />Permit to alter monitoring <br />for underground piping & UDC <br />system <br />9.. <br />CCR 2636 (c)(1) <br />is present (M1) 29—HSC 25298 (a) <br />All releases in secondary piping <br />illegal abandonment of UST <br />system <br />10 <br />HSC 25291 (f) <br />flow to a collection sump 30 HSC 25298 (b) <br />Line leak detector(s) (M1) <br />Permit to temporarily close US' <br />11 <br />HSC 25291(a)(2) <br />Secondary containment for 31.. HSC 25298 (c) <br />system <br />Permit to close UST system <br />12 <br />CCR 2635 (b)(1) <br />UST is tight 32 HSC 25292.1 <br />Spill container (M2) <br />UST system is operated to <br />prevent unauthorized release <br />13 <br />HSC 25284,2 <br />Annual spill container testing 33 CCR 2650 <br />Recording/reporting <br />14 <br />CCR 2635 (b)(2) <br />Overfill prevention system (M2) <br />unauthorized release (M1) <br />15 <br />CCR 2631 (s) <br />Primary containment is product- 34 HSC 25291 (e) <br />Water in 2° cont analyzed and <br />16 <br />CCR 2632 (d) <br />tight <br />Monitoring & response plan 35 CCR 2640 (e) <br />properly disposed of <br />Single wall component within <br />17 <br />CCR 2712 (1) <br />Monitoring & response plan is <br />1 000'of Public Well, no ELD <br />18—v—" <br />CCR 2712 (b) <br />on site 36 CCR 2635(a)(2)(A) <br />Maintenance & monitoring ' <br />Cathodic protection testing & <br />6o day inspection log (M2) <br />records (M1) 37. H&SC 25299(x)(9) Disabling leak detect. Devices <br />19 <br />OCR 2636 (f)(4) <br />Annual line tightness test 38 CCR 2715(a) <br />Statement from UST owner' <br />20 <br />C,CR 2630 (d) <br />Annual line leak detector test 39 CCR 2715(c) <br />Monthly inspection by 0.0. <br />21 <br />(M1) 40 CCR 2715 (f) <br />D.O. trained employees <br />CCR 2630 (d) <br />Annual monitoring certification 41 <br />Violation(s) not listed above <br />22 <br />CCR 2661 (f) <br />Repair for tank/piping has had <br />tightness test M2 <br />EHD INSPECTOR: <br />A��& PHONE:i <br />�jL <br />RECEIVED BY: <br />TITLE: <br />Septic System: <br />D Serves z 20 persons/day 0 Receives other than sanitary waste <br />Other Disposal <br />Units Identified_ 0 Dry wells/French Drains <br />k1Un1Is1Vni1-III\USTt!$Tinspepion8.18.06.DOC <br />' <br />