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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <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) PROGRAM <br />INSPECTION REPORT <br />Facility name: <br />Designated Operator: Inspection <br />C9tA-C 2205-44-3 <br />Date: <br /><9-5 - L <br />Facility address: <br />UST # <br />CCR 2637 <br />Product,.,-- <br />Facil' ,Contact: Title: Phone: <br />,1' <br />CCR 2711 (b) & (c) <br />Current Unified Program Consolidated Forms on file with EHD (Facility and tank form) <br />M n' ring anel: <br />Piping system: Ij <br />Piping <br />Overfill prevention: <br />Certification of financial responsibility and CFO letter <br />0 Suction 11 Gravity <br />echanical 0 Audible/visual <br />FnsIe;ctilon type: <br />I p <br />Violations: <br />Routi, 31vo itoring Certification 0 Installation 0 Other: <br />Routine <br />LqMl-R Detect 0 M2 -RPrev N�M_3 Both <br />iii <br />EHD 23-02-002 REV 8/08 <br />Septic system: <br />0 Serves ��20 people/day <br />0 Receives other than sanitary waste <br />Other disposal methods: <br />0 Dry wells/French Drains <br />LIST INSPECTION FINAL <br />Code Section <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=California Code of Regulations v K <br />V=Violation; RV=Repeat Violation V <br />1 <br />HSC 25284 <br />Permit tooperate <br />2 <br />CCR 2637 <br />Secondary 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 />Monitorin Program (Monitoring & Response Plan) is current and approved b the local agency. <br />CCR 2712 (i) <br />Monitoring plan is onsite. <br />X I, <br />7 <br />1 <br />Maintenance & monitoring records <br />(MI) <br />F6 <br />CCR 2643 (d) <br />Daily monitoring of suction piping (pre -January, 1, 1984) <br />9 <br />HSC 25292.1 <br />LIST system isoperated to pLevent unauthorized release <br />10 <br />9 <br />_ <br />CCR 2632 (c)(2) <br />UST monitoring system is present <br />(MI) <br />11 <br />CCR 2630 (d) <br />LIST system monitoring equipment is properly located to detect a, leak <br />(MI) X <br />12 <br />HSC 25291 (b) <br />LIST system monitoring equipment is operational <br />(MI) I W <br />13 <br />CCR 2636 (f)(1) <br />Continuous monitoring system for underground iping & UDC is present <br />(MI) <br />14 <br />CCR 2631 (a) <br />Primary containment is eroduct tight <br />15 <br />HSC 25291 a 2) <br />Secondary containment for LIST is tight <br />16 <br />CCR 2636 (c)(1) <br />All releases in secondary 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 />Spill container <br />(M2)_X_ <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 & 20 containment <br />21 <br />HSC 25291 (e) <br />Water in 20 containment analyzed & properly disposed of <br />22 <br />CCR 2650 <br />Recording/reporting of unauthorized releases <br />(MI) <br />23 <br />CCR 2715 <br />Designated Operator: (a) Statement from UST owner; (c -e) Monthly inspection; (1) Em2loyee trainin� <br />24 <br />CCR 2638 (a) <br />Annual monitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test <br />(MI) <br />26 <br />1 HSC 25284.2 <br />Annual spill containment testing <br />27 <br />CCR 2636 (f)(4) <br />Annual line tightness test <br />(MI) <br />28 <br />CCR 2661 (f) <br />Repair for tank/piping has had tightness test <br />(M2) <br />29 <br />CCR 2643 (e) <br />Biennial tightness test of gravity pipin2 (pre -January 1, 1984) <br />30 <br />CCR 2643 (d) <br />Triennial line test for conventional suction piping (pre -January 1, 1984) <br />31 <br />HSC 25292.5 <br />Double wall system located within 1000' of eublic well-ELD <br />32 <br />CCR 2661 <br />Permit to repair UST system <br />33 <br />HSC 25286 (a) <br />Permit to alter monitorina 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 />(a)(9)(0(2) <br />Disabling leak detection devices <br />37 <br />HSC 25298 (a) <br />illegal abandonment of LIST system <br />Other: <br />iii <br />EHD 23-02-002 REV 8/08 <br />Septic system: <br />0 Serves ��20 people/day <br />0 Receives other than sanitary waste <br />Other disposal methods: <br />0 Dry wells/French Drains <br />LIST INSPECTION FINAL <br />