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FT4D 23-02-002 <br />SAN dOAQUIN COUNTY <br />QVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3`d Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjjzov.orwehd <br />UNDERGROUND STORAGE TANK JUST2 PROGRAM INSPECTION REPORT <br />Facility name: Designated Operator: <br />left <br />Inspection Date: <br />C5—+ <br />s <br />Facility address: UST # <br /><[_r <br />Product <br />4 <br />91 <br />Facility Contact: <br />�►iwc� �1� <br />Title: Phone: <br />r��. • u��� p_,� �� 1? <br />Monitoring Panel: <br />Cp f <br />Piping system: Overfill prevention: <br />[Aressurized ❑ Suction ❑ Gravity OMechanical ❑ Audible/visual <br />'Inspection type: <br />Routine C/Nolonitoring <br />Violations: <br />Certification ❑ Installation ❑ Other: 11 M1-RDetect ❑ M2-RPrev ❑ M-3 Both <br /># <br />Code Section <br />VIOLATION(S) HSC=California Health & Safety Code; CCR=California Code of Regulations V R <br />V=Violation; RV=Re eat Violation V <br />1 <br />HSC 25284 <br />Permit too erate <br />2 <br />CCR 2637 <br />Secondary containment test perfornied <br />3 <br />CCR 2711 b & c <br />Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br />HSC25292.2 <br />Certification of financial responsibility and CFO letter <br />5 <br />CCR 2632 c 2 D <br />Monitoring & response 21an is current and filed with the local agency <br />�.; < <br />.: ,CGR712i <br />Monitoring & res nse plan is onsite,✓ <br />7 <br />CCR 2712 <br />Maintenance & monitorin records Ml ✓ <br />g <br />CCR.1643 d <br />Daily monitoring of suction piping (pre -January, 1, 1984 <br />9 <br />1 HSC 25292.1 <br />UST system iso erated to prevent unauthorized release <br />J0 <br />CCR -2632 (cX2) <br />UST monitoring system is gresent MI <br />1 I <br />CCR 2630 d <br />UST system monitoring a ui ment is properly located to detect a leak Ml <br />12 <br />HSC 25291' <br />UST system monitoring equipment isoperational M2 <br />13 <br />CCR 2636 1 <br />Continuous monitoring system for underground piping & UDC is present Ml <br />`l <br />CCR 2631' a <br />Primary containment is 2roduct tight <br />15 <br />HSC 25291 (a(2) <br />Secondary containment for UST is tight <br />jk <br />e,,. `CC9 X636. c 1 <br />All releases in secondary piping flow to a collection sum <br />17 <br />HSC 25291 <br />Line leak detectors are installed Ml <br />Spill container M2 <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system M2 <br />t C >22636 (a) <br />Conventional suction piping shall have continuous monitoring & 20 containment <br />21 <br />HSC 25291 (e) <br />Water in 2° containment analyzed & properly disposed of <br />22 <br />CC)It 2650 <br />Recording/reporting of unauthorized releases Ml <br />23 <br />CCR 2715 <br />Designated Operator: (a) Statement from UST owner; (c -e) Monthly inspection; Employee trainin <br />24 <br />1, CCR 2638 a <br />Annual monitoring certification <br />25 <br />CCR 2638 a <br />Annual line leak detector test M1 <br />26 <br />HRC 25284.2 <br />Annual spill containment testing <br />27 <br />CCR 2636 4 <br />Annual line ti htness test Ml <br />21L <br />!CCk2661 i <br />Repair for tank/piping has had tightness test M2 <br />29 <br />CCR 2643 a <br />Biennial 'tightness test of gravity pipingre-Janus 1, 1984 <br />2643 d <br />Triennial line test for conventional suction piping (pre-January1, 1984 ; M1 -_ <br />31 <br />HSC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <br />3L <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' <br />Permit to tem orarily close UST system <br />35 <br />1 HSC 25298 c <br />Permit to close UST system <br />HSC 25299 (a)(9) <br />Disablingleak detection devices <br />1'`,36'' <br />37 <br />HSC 25298 a <br />Illegal abandonment of UST system <br />18, <br />Other: <br />EHD INSPECTOR: <br />t t7 <br />1 '� ( T <br />PHONE: UIC <br />Septic system: <br />' ' '' • 631 ❑ Serves >_20 people/day <br />TITLE ❑ Receives other than sanitary waste <br />it Other disposal methods: <br />0 wells/French Drains <br />RE LVED BY: <br />FT4D 23-02-002 <br />