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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sicehd.com <br /> i' <br /> Facility Facility Inspection <br /> Name: Address: Date: <br /> 330 1 CCR 2717.1(0 Deposited petroleum into a red tagged UST(V746) ❑ ❑ ❑ <br /> 331 HSC 25299(f)(2) Tampered with or disabled leak detection devices or alarms(V692) ❑ ❑ ❑ <br /> 332 CCR 2631.1 UST system not compatible with the substance stored(V751) ❑ ❑ ❑ <br /> 333 HSC 25298(b) Failed to comply with temporary closure requirements(V747) ❑ ❑ ❑ <br /> 334 HSC 25298(c) Failed to comply with permanent closure requirements(V748) ❑ ❑ ❑ <br /> 401 CCR 2636(a)(3) Suction piping not properly sloped or incorrectly located check valve(V705) ❑ ❑ ❑ <br /> 402 CCR 2643(d) Daily monitoring of suction pipe(pre-Jan 1984)not performed(V726) Cl ❑ <br /> 403 CCR 2643(d) Triennial 0.1 gph line test for conventional suction piping not performed(pre-January 1984)(V664) ❑ ❑ ❑ <br /> 404 CCR 2643(e) Biennial 0.1 gph test for gravity piping not performed(pre-January 1984)(V665) ❑ ❑ ❑ <br /> O o s <br /> ago= <br /> 2010 See below Unlisted Administration/Documentation violation(V736) ❑ ❑ ❑ <br /> 2030 See below Unlisted Operations/Maintenance violation(V743) ❑ ❑ ❑ <br /> 2060 See below Unlisted Design/Construction violation(V745) ❑ ❑ ❑ <br /> F <br /> xr <br /> e L <br /> .Z c <br /> Viaeif <br /> ,(, <br /> a ` T <br /> a � f <br /> r � <br /> c <br /> E <br /> a t" � <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> R 'ved by(signature): Title: Date: <br /> r 6 � <br /> LKE ceived by(printed name): Inspector- Inspector phone: <br /> EHD 23-01 REV 08/07/15 Page 3 ST INSPECTION REPORT <br />