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SAN JOAQUIN COUNTY <br />*NVIRONMENTAL HEALTH DEPARTMENT 40 <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax. (209) 468-3433 Web: www.sigov.org/ehd <br />UNDERGROUND STORAGE TANK UST PROGRAMINSPECTION REPORT <br />Facility name: Designated Operator: <br />�.. 4y 1 <br />Facility address: UST #"' <br />a <br />'Product <br />Inspection <br />Date: <br />J <br />Fac' <br />ity ContactTitle: <br />j Phone: <br />i ring Panel: Piping system: Overfill prevention: <br />07 <br />07>1 ressurized ❑ Suction ❑ Gravity echanical ❑ Audible/visual <br />In pectio type: Violations: <br />outine Nyonitoring Certification ❑ Installation ❑ Other: El M1-RDetect 0 M2-RPrev 0 M-3 Both <br /># <br />Code Section <br />VIOLATION(S) HSC=Califomia Health & Safety Code; CCR=Califomia Code of Regulations TVR <br />RV=Re eat Violation <br />1 <br />HSC 25284 <br />Permit to o erateV=Violation; <br />2 <br />CCR 2637 <br />Seconda containment test performed <br />3 <br />CCR 2711 b & c <br />Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br />4 <br />HSC 25292.2 <br />Certification of financial responsibility and CFO letter <br />5 <br />CCR 2632 b <br />Monitoring Program(Monitoring & Res22nse Plan is current and approved by the local agency. <br />6 <br />CCR 2712 i <br />Monitoring plan is onsite. <br />7 <br />CCR 2712 b <br />Maintenance & monitoring records <br />M1 <br />8 <br />CCR 2643 d <br />Daily monitoring of suction piping (pre -January, 1, 1984 <br />9 <br />HSC 25292.1 <br />UST system isoperated to prevent unauthorized release <br />10 <br />11 <br />CCR 2632 (c)(2) <br />CCR 2630 d <br />UST monitoring system is present <br />UST system monitoring equipment is properly located to detect a leak <br />(M1 <br />M1 <br />12 <br />HSC 25291 b <br />UST system monitorin a ui menf isoperational <br />RA1 <br />13 <br />CCR 2636 1 <br />Continuous monitoring system for underground pi.ping & UDC is present <br />M1 <br />14 <br />CCR 2631 a <br />Primary containment is product tight <br />15 <br />HSC 25291 (a)(2) <br />Secondary containment for UST is tight <br />16 <br />1 CCR 2636 (c)(1) <br />All releases in secondary piping flow to a collection sum <br />17 <br />HSC 25291 <br />Line leak detectors are installed <br />M1 <br />18 <br />19 <br />CCR 2635 (b)(1) <br />CCR 2635 (b)(2) <br />Spill container <br />Overfill prevention system <br />(M2 <br />1012 <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 20 containment <br />21 <br />1 HSC 25291 (e) <br />Water in 20 containment analyzed & properly disposed of <br />22 <br />1 CCR 2650 <br />ReGording/reporting of unauthorized releases <br />M4 <br />24 <br />CCR 2715 <br />CCR 2638 a <br />Designated Operator: a Statement from UST owner; (c -e) Monthly inspection; Em to ee training <br />Annual monitoring certification <br />123 <br />25 <br />26 <br />CCR 2638 a <br />HSC 25284.2 <br />Annual line leak detector test <br />Annuals ill containment testin <br />M1 <br />'27 <br />28 <br />29 <br />CCR 2636 4 <br />CCR 2661 <br />CCR 2643 a <br />Annual line tightness test <br />Repair for tank/ iping has had tightness test <br />Biennial tightness test of gravity piping(pre-January 1, 1984 <br />M1 <br />(M2 <br />30 <br />31 <br />CCR 2643 d <br />HSC 25292.5 <br />Triennial line test for conventional suction piping (pre-January1, 1984 <br />Double walls stem located within 1 000'of public well-ELD <br />M1 <br />32 <br />CCR 2661 <br />Permit to repair UST system <br />33 <br />HSC 25286 a <br />Permit to alter monitoring system <br />34 <br />HSC 25298 b <br />Permit to temporarily close LIST system <br />35 <br />HSC 25298 c <br />Permit to close UST system <br />36 <br />HSC 25299 <br />__O)(9)(Q(2) <br />Disabling leak detection devic s <br />37 <br />HSC 25298 a <br />Illegal abandonment OfUSIlystem <br />38 Other: <br />EHD INSPECT <br />tl di <br />PHONE. UIC <br />Septic system: <br />❑ Serves z20 peoplelday <br />RECEIVED BY: TITLE: ❑ Receives other than sanitary waste <br />Other disposal methods: <br />❑ Dry wells/French Drain- <br />EHD 23-02-002 REV 8/08 <br />