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SAN JOAQUIN COUNTY <br /> ONVIRONMENTAL HEALTH DEPARTMEN <br /> A"y 304 East Weber Avenue,3`a Floor,Stockton,CA 9520 -2708 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sj o�v_org/ehd <br /> UNDERGROUND STORAGE TANK USTJ PROGRAMINSPECTION REPORT <br /> Facility name: ff Designated Operator: Inspection Date: <br /> Facility address: UST# <br /> /q I ty - 3 <br /> 2, Product <br /> 5 `11 ``` � S Product <br /> Facility Contact: Title: Phone: <br /> Monitoring Panel: Piping system: Ove fill prevention: <br /> VA ILS a5v (Pressurized ❑Suction ❑Gravity Mechanical ❑Audible/visual <br /> Inspection type: Violations: <br /> E4outine OKmonitoring Certification ❑Installation ❑Other: ❑Ml-RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATIONS) HSC=California Health&Safety Code;CCR=California Code of Regulations V R V=Violation;RV=Re eat Violation V <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR 2637Secondary containment test performed <br /> 3 CCR 2711 b & c Current Unified Pro am Consolidated Forms on file with EHD(Facility and tank form <br /> 4 HSC 25292.2 Certification of financial reMonsibility and CFO letter <br /> 5 CCR 2632 c 2 D Monitoring&res onse plan is current and filed with the local agency <br /> 6 CCR 2712' i Monitoring res onse. lan'is onsite <br /> 7 CCR 2712 b Maintenance&monitoring records l <br /> 8' CCR 2643; d Daily monitorin of suction i in re-January, 1, 1984 <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST rnonit2!jag s stem is present 1 <br /> I I CCR 2630 d UST system monitoring a ui ment is=rly located to detect a leak l <br /> 12 HSC 25291 UST system mobitorina 292fpment is operational M2 <br /> 13 CCR 2636 1 Continuous monitoring system for under ound pi2ing&UDC is present l <br /> 14 CCR 2631' a PriTaa containment is product tight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> s16 CCR 2636'(c)(1) All releases in second i i flow to a collection sump <br /> 17 HSC 25291 (D Line leak detectors are installed l <br /> 15 1 CCR 2635'' 1 Spill container M2 <br /> 19 CCR 2635 2 Overfill prevention system M2 <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&20 containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Recordin re ortin"of unauthorized releases' Mi <br /> 23 CCR 2715 Designated erator:(a)Statement from UST owner; c-e Monthly ins ection; Em to ee training <br /> 24 j CCR2638 a Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test l <br /> 26 HSC 25284.2 Annual spill containment testing <br /> 27 CCR 2636 4 Annual line tightness test i <br /> 28 CCR 2661 Repair for tanLJpiping has had ti tress test 2 <br /> 29 CCR 2643 e Biennial tightness test of Eavity pipingre-Janu 1, 1984 <br /> 3 CCR 2643' d Triennial line test for conventional suction 2iping(pre-January1,1984 ML <br /> 31 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to re air UST's stem <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> 34 HSC 25298 ) Permit to tone aril close UST s stem <br /> 35 HSC 25298 c Permit to close UST system <br /> .36 1 HSC 25299(a)(91 Disabling leak detection devices <br /> 37 HSC 25298 a Illegal abandonment of UST system <br /> 38-j Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> O/Z 4- �0 & Septic system: <br /> l ❑Serves>_20 people/day <br /> RECEIV D BY: zn TITLE: ❑Receives other than sanitary waste <br /> ® tC� Other disposal methods: <br /> ❑Dry wells/French Drains <br /> FHT)23-02-002 <br />