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SAN JOAQUIN COUNTY <br />VIRONMENTAL HEALTH DEPARTMENT <br />304 Eas * eber Avenue, 3`d Floor, Stockton, CA 95202- 8 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.s_jgov.or <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility name: <br />G�*►s �S�'S G>r�R, t+.lAs� <br />Designated Operator: <br />�v►J �scr-��� <br />Inspection Date: <br />c7�^-' t 9 –off <br />Facility address: <br />1S. -tk V VER 61.. <br />UST # <br />Product <br />91 <br />8 <br />Facility Contact: <br />`-.0 L cAl-L>7Pq <br />Title: Phone: <br />w-uAGeR 9'-48 –1 &3'(0 <br />8�-- <br />Monitoring Panel: <br />— S� <br />Piping system: <br />Pressurized 11 Suction ❑ Gravity <br />O,vveerSll prevention: <br />.u�° Mechanical ❑ Audible/visual <br />Inspection type: <br />Routine onitoring Certification ❑ Installation ❑ Other: <br />Violations: <br />❑ M1-RDetect ❑ M2-RPrev ❑ M-3 Both <br /># <br />Code Section <br />VIOLATIONS) 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 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 c (2)(D) <br />Monitoring & response plan is current and filed with the local agency <br />6 <br />CCR 2712 i <br />Monitoring & response plan is onsite <br />7 <br />CCR 2712 b <br />Maintenance & monitoring records 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 />CCR 2632 (c)(2) <br />UST monitoring system is present (Mi) <br />11 <br />CCR 2630 (d) <br />UST system monitoring equipment is properly located to detect a leak M1 <br />12 <br />HSC 25291 <br />UST system monitoring equipment isoperational M2 <br />13 <br />CCR 2636 (f)(1) <br />Continuous monitoring system for underground piping & UDC is present (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 />CCR 2636 (c)(1,) <br />All releases in secondary piping flow to a collection sump <br />17 <br />HSC 25291 ( <br />Line leak detector(s) are installed (Ml) <br />18 <br />CCR 2635 (b)(1) <br />Spill container (M2) <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system N12 <br />20 <br />CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 2° containment <br />21 <br />HSC 25291 (e) <br />Water in 2° containment analyzed & properly disposed of <br />22 <br />CCR 2650 <br />Recording/reporting of unauthorized releases Mi <br />23 <br />CCR 2715 <br />Designated Operator: (a) Statement from UST owner; (c -e) Monthly inspection; (f) Employee training <br />24 <br />CCR 2638 a <br />Annual monitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test (M1) <br />26 <br />HSC 25284.2 <br />Annual spill containment testing <br />27 <br />CCR 2636 (4) <br />Annual line tightness test Ml <br />28 <br />CCR 2661 (f) <br />Repair for tank/piping has had tightness test (M2) <br />29 <br />CCR 2643 (e) <br />Biennial tightness test of gravity pipingre-Januar 1, 1984 <br />30 <br />CCR 2643 d) <br />Triennial line test for conventional suction piping (pre -January 1, 1984) (Mi) <br />31 <br />HSC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <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 UST system <br />35 <br />HSC 25298 (c) <br />Permit to close UST system <br />-36 <br />HSC 25299 (a)(9) <br />Disabling leak detection devices <br />37 <br />HSC 25298 a) <br />Illegal abandonment of UST system <br />38 <br />Other: <br />EHD INSPECTOR: <br />C` <br />PHONE: <br />44 Q -03q-1 <br />(Ul `' 1 <br />UIC <br />Septic system: <br />^ 0 Serves >_20 people/day <br />❑ Receives other than sanitary waste <br />Other disposal methods: <br />❑ Dry wells/French Drains <br />R CEI E BY: <br />TITLE: <br />EHD 23-02-002 <br />