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08/26/2004 12:41 2094683433 FIFTH FLOOR PAGE 02 <br /> SAN JOAQUIN COUNTY UA I t_ Zs��prQy <br /> ONVIRONMENTAL HEALTH DEPARTMENT PAGE_L ` <br /> 304 E.Weber Ave.,Third Floor,Stockton, CA 95202 <br /> (209)468-3420, <br /> UNDERGROUND STORAGE TANK(UST),PROGRAM INSPECTION REPORT <br /> Facility Name IC, Facility Address <br /> Facilty Contact Titlejff^wgefphone# LOL cKY �p <br /> UST#—L Product_ q1 UST# ?,Product 9 7 ST# Product UST# Product <br /> Overfill Prevention; ❑AudibleArispl ❑Mechanical Monitoring Panel: 4�W415* L4 <br /> Piping System: D Gravity LrPressure ❑Suction Violations:0 M1-RDet ❑M2-Rprev ❑M3-B0th <br /> Automatic PUME Shut Down Satisfies CCR263fi(f)(5): 4 Yes❑ No Designated Operator: <br /> INSPECTION TYPE: ❑Routine i lMonitoring Certification ❑Complaint Oinstall ❑Removal ❑Repair/Upgrade <br /> COMPANY NAME: ' TECHNICIAN NAME: PHONE: <br /> ViOLATiON(S) <br /> The above facility is not in compliance with the following section(s)of Health &Safety Code (HSC)and/or <br /> California Code of Regulations(CCR): <br /> 1 NSC 25284 Permit to operate 23 CCR 2643 (d) Daily monitoring of suction <br /> 2�CCR 2637 Secondary cont.testing piping(pre-1/1/84) <br /> 3 CCR 2711(b)&(e) Current State Forms A& B 24_CCR 2636(a) Conventional suction.piping <br /> 4 HSC 25292.2 Certification of financial shall have continuous <br /> responsibility& CFO letter monitoring&20 containment <br /> 5 CCR 2632(c)(2) UST monitoring is present(M1) 25 CCR 2643.(e) Biennial tightness test of gravit, <br /> 6�CCR 2630(d) UST system monitoring piping (pre-1/1/84) <br /> equipment is properly located to 26 CCI 2643(d) Trienrlial.line test for <br /> detect a leak(M1) conventional suction (pre- <br /> 7 CCR 2637(b) UST system monitoring 1/1/84) (M1) <br /> equipment is operational(M1) 27 CCR 2661 Permit to repair UST system <br /> 8 CCR 2636(f)(1) Continuous monitoring system 28 HSC 25286 (a) Permit to atter monitoring <br /> for underground piping.& UDC system <br /> is present(M1) 29 HSC 25298(a) Illegal abandonment of UST <br /> 9 CCR 2636(c)(1) All releases in secondary piping system <br /> flow to a collection sump 30 HSC 25298 (b) Permit to temporarily close US' <br /> 10 HSC 25291 (f) Line leak detector(s)(M1) system <br /> 11 HSC 25291(a)(2) Secondary containment for 31 HSC 25298(c) Permit to close UST system <br /> UST is tight 32 HSC 25292.1 UST system is operated to <br /> 12 CCR 2635(b)(1) Spill container(M2) prevent unauthorized release <br /> 13:ZHSC 25284.2 Annual spill container testing 33 CCR 2650 Recording/reporting <br /> 14_._ CCR 2635•(b)(2) Overfill prevention system(M2) unauthorized release(M1) <br /> 15 CCR 2631 (a) Primary containment is product-: 34 HSC 25291 (e) Water in 211 cont analyzed and <br /> tight properly disposed of <br /> 16OR 2632(d) Monitoring&response plan 35 CCR 2640(e) Single wall component within <br /> 17 CCR 2712 (1) Monitoring&response plan is 1 000'of Public Well, no ELI) <br /> on site 36 CCR 2635(a)(2)(A)Cathodic protection testing & <br /> 18CCR 2712(b) Maintenance&monitoring 60 day inspection log(M2) <br /> records(M1) 37 H&SC 25299(a)(9)Disabling leak detect. Devices <br /> 19 CCR 2636(f)(4) Annual line tightness test 38 CCR 2715(a) Statement from UST owner <br /> 20 CCR 2630(d) Annual line leak detector test 39 CCR 2715(c) Monthly inspection by D.O, <br /> (M1) 40 CCR 2716 (f) D.O.trained employees <br /> 21 CCR 2630(d) Annual monitoring certification 41 Violation(s)not listed above <br /> 22 CCR 2661 (f) Repair for tank/piping has had <br /> ti htnes test M2 <br /> EHD INSPECTOR: A<�� <br /> PHONE: 5 IfA 83 0 <br /> RECEIVED BY: TITLE: <br /> Septic System. 0 ery 2 20 persons/day 0 Receives other than sanitary waste <br /> Other Disposal Units Identified: 0 Dry wells/French Drains <br /> I:UNM1Un11-IInUSrdXT inpped40n8.19.04.0M <br />