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SAN JOAQUIN COUNTY <br />IRONMENTAL HEALTH DEPARTMENT T <br />304 East Weber Avenue, 3`d Floor, Stockton, CA 95202-2 08 <br />Telephone. (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility name: <br />HSC 25291 (e) <br />Designated Operator: <br />Inspection Date: <br />I <br />HSC 25284 <br />Permit tooperate <br />CCR 2715 <br />2 <br />CCR 2637 <br />Secondary containment test peffiarmed <br />Annual monitoring certification <br />Facility address: <br />CCR 2711 (§) & (c) <br />UST # <br />26 <br />4 <br />HSC 25292.2 <br />t-t'F_R LA_ -1 <br />✓ <br />Product <br />CCR 2632 (c)(2)(D) <br />Monitoring & res2onse Elan is current and filed with the local agency <br />Re air for tank/�i in has had tightness test <br />Facility Contact: Title: <br />Phone: <br />Monitoring & response plan is onsite <br />30 <br />7 <br />CCR 2712 Lb) <br />C> <br />(Mi) <br />8 <br />CCR 2643'(d) <br />Daily monitoring of suction piping (pre -January, 1, 1984) <br />Monitoring Panel: <br />Piping system: <br />HSC 25292.1 <br />Overfill prevention: <br />'TLS - <br />/Pressurized <br />11 Suction 11 Gravity <br />0 11 Mechanical /Audible/visual <br />Inspection type: <br />I I <br />Violations: <br />/Routine Monitoring Certification <br />11 Installation 11 Other: <br />LZM1-RDetect 0 M2-RPrev ❑ M-1 Anti, <br />I# Code Section VIOLATION(S) HSC=California Health & Safety Code; CCk=Califomia Code of Regulations V I R 11=xr; I ;• DXI=D — IT; ]_; V <br />21 <br />HSC 25291 (e) <br />0 at on; e ea to a ton <br />22 <br />I <br />HSC 25284 <br />Permit tooperate <br />CCR 2715 <br />2 <br />CCR 2637 <br />Secondary containment test peffiarmed <br />Annual monitoring certification <br />3 <br />CCR 2711 (§) & (c) <br />Current Unified Program Consolidated Forms on file with EHD (Facility and tank form) <br />26 <br />4 <br />HSC 25292.2 <br />Certification of financial responsibility and CFO letter <br />✓ <br />5 <br />CCR 2632 (c)(2)(D) <br />Monitoring & res2onse Elan is current and filed with the local agency <br />Re air for tank/�i in has had tightness test <br />6 <br />1 CCR 2712', i) <br />Monitoring & response plan is onsite <br />30 <br />7 <br />CCR 2712 Lb) <br />Maintenance & monitoring records <br />(Mi) <br />8 <br />CCR 2643'(d) <br />Daily monitoring of suction piping (pre -January, 1, 1984) <br />Permit to r'- air UST system <br />9 <br />HSC 25292.1 <br />UST system isoperated to prevent unauthorized release <br />34 <br />10 <br />CCR 2632 (c)(2) <br />UST monitorina system is present <br />(Mi) <br />I I <br />CCR 2630 (d) <br />sstem monitoring equipment is j2ro]2erly located to detect a leak <br />(MI) <br />12 <br />HSC 25291 (b) <br />_UST <br />UST s stem equipment iso2erational <br />(M2) <br />13 <br />CCR 2636 (f)(1) <br />-monitoring <br />Continuous monitoring system for underground piping & UDC is present <br />(Mi) <br />14 <br />CCR 2631' (a) <br />Primary containment is product tight <br />15 <br />HSC 25291 a 2) <br />Secondary containment for UST inti <br />L16 <br />CCR 2636 (c)(1) <br />All releases in second 2a piping flow to a collection sump <br />17 <br />HSC 25291 (f) <br />Line leak detector(s) are installed <br />(MI) <br />18 <br />CCR 2635(b)(1 <br />SLill container <br />(M2) <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system <br />(M2) <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 2' containment <br />21 <br />HSC 25291 (e) <br />Water in 2' containment analyzed & properly disgosed of <br />22 <br />CCR 2650 <br />Recording/reporting of unauthorized releases <br />23 <br />CCR 2715 <br />Desig2ated Operator: (a) Statement from UST owner; (c -e) Monthly inspectio <br />24 <br />CCR 2638 a <br />Annual monitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test <br />26 <br />HSC 25284.2 <br />Annu I spill containment testing <br />27 <br />CCR 2636 (f)(4) <br />Annual line tightness test <br />28 <br />CCR 2661 (f) <br />Re air for tank/�i in has had tightness test <br />29 <br />CCR 2643 (e) <br />Biennial tightness test of Eavity Ri2inre-January 1, 1984) <br />30 <br />CCR 2643' <br />Triennial line test for conventional suction 2!ping (re-Janu2g 1, 1984 <br />31 <br />HSC 25292.5 <br />Double wall system located within 1000' of public well-ELD <br />32 <br />CCR 2661 <br />Permit to r'- air UST system <br />33 <br />HSC 25286 (a) <br />Permit to alter monitoring system <br />34 <br />HSC 25298 <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 />Other: <br />EHD INSPECTOR: <br />—4w— <br />PHONE: <br />L C45 -j <br />RECEIVE s <br />TITLE: <br />FHD 23-02-002 <br />(Mi) ,- <br />(Mi) <br />(M2) <br />(Mi) <br />UIC <br />Septic system: <br />11 Serves ��20 people/day <br />11 Receives other than sanitary waste <br />Other disposal methods: <br />11 Dry wells/French Drains <br />