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SAN JOAQUIN COUNTY <br /> A <br /> NVIRONMENTAL HEALTH DEPARTMENT <br /> 304 Ea Weber Avenue,3rd Floor, Stockton,CA 95202 708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjpov.org/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> L-N�- <br /> Facility address: UST# <br /> Product J D� <br /> Facility Contact: Title: Phone: <br /> Monitoring Panel: Piping syste2E� l/ Overfill prevention: <br /> is ILFjAV Pressurize Suction�� ❑Gravity echanica Audible/visual <br /> Inspection type: Violations: <br /> Routine Monitoring Certification 11 Installation El Other: ❑M1-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V R V=Violation;RV=Re eat Violation V <br /> I HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 & 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 Ml <br /> I 1 CCR 2630(d) UST system monitoring equipment is properly located to detect a leak Ml <br /> 12 HSC 25291UST 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 (a2(2) Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in secondary piping flow to a collection sum <br /> 17 HSC 25291 Line leak detector(s)are installed Ml <br /> 18 CCR 2635',(b)(l) Spill container M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system M2 <br /> 20 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 CCR 2650 Recording/reporting of unautborized releases M1' <br /> 23 CCR 2715 Desi ated Operator:(a)Statement from UST owner; (c-e)Monthly inspection; Em loyee 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 Annual spill containment testing <br /> 27 CCR 2636 4) Annual line tightness test (Ml) <br /> 28 CCR 2661(f) Repair for tank/piping has had tightness test (M2) <br /> 29 CCR 2643(e) Biennial tightness test of gravity piping( re-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 CCR 2661 Permit to repair UST system <br /> 33 1 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 /> WlW4 N d� Cc - Se tpicsystem: <br /> Serves>_20 people/day <br /> REC E 3 BY: T TLE:,' ❑Receives other than sanitary waste <br /> "Ino)d( 0 Other disposal methods: <br /> Dry wells/French Drains <br /> V tOt,Arro�� � <br /> EHD 23-02-002 <br />