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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.sigoy.org/ehd <br /> UNDERGROUND STORAGE TANK UST) PROGRAM INSPECTION REPORT <br /> Facility name: Desj' nated Operator:aInspection Date: <br /> '�tki - 1� <br /> Facility address- UST# <br /> aI,- ro uct E' <br /> Facility Contact: Title: Phone: <br /> MIA�L <br /> ( L <br /> Monitoring Panel: Piping system: Overfill prevention: <br /> C ,orin, a <br /> '(1" V Pressurized El Suction El Gravity Mechanical El Audible/visual <br /> Inspection type: I Violations: <br /> 10 Routine )dMonitoring Certification El Installation 11 Other: El M I-RDetect OM2-RPrev El M-3 Both <br /> I VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations R <br /> # Code Section V=Violation;RV=Repeat Violation V <br /> I HSC 25284 Permit to.operate <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 (b)&'(c) Current Unified Pro am Consolidated Forms on file with EHD(Facility and tank form) <br /> 4 HSC 25292.2 Certification of financial res2onsibility and CFO letter <br /> 5 CCR 2632 b) Monitoring Program(Monitoring&Response Plan)is current and approved by the local a enc <br /> 6 CCR 2712(i) Monitoring plan is onsite. <br /> 7 -CCR 2712(b) Maintenance&monitoring records (M 1) <br /> 8 CCR 2643(d) Daily monitoring of suction 2iging(2re-JanuM, 1, 1984) <br /> -9 HSC 25292.1 UST sXstem isoperated to prevent unauthorized release <br /> 10 CCR 2632(c)(2) UST monitoring system is present (M 1) <br /> I I CCR 2630(d) UST system monitoring equi2ment is properly located to detect a leak (M 1) <br /> 12 1 UST system L!mEo2nniitlo2rtiEng&SeqHiEE222Liso tionaI (M2) <br /> 13 CCR 2636(f)(1 Continuous monitoring system for underground 2i,in &UDC ispresent (M1) <br /> 14 CCR 2631 (a) Primary containment is product tight <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in second2a piping flow to a collection sump <br /> 17 HSC 25291 (D Line leak detector(s)are installed (M 1) <br /> 18 CCR 2635 b) 1) S2ill container (M2) <br /> 19 CCR 2635 b)(2) Overfill prevention system (M2) <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&2'containment <br /> 21 HSC 25291 (e) Water in 2'containment analyzed&2roperly disposed of <br /> 22 CCR 2650 Recording/EMorting of unauthorized releases (M 1) <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly inspection,(f)Employee trainipj_ <br /> 24 CCR 2638(a) Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (M1) <br /> 26 HSC 25284.2 Annual spill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test (M 1) <br /> 28 CCR 2661 (f) Repair for tank/piping has had tightness test (N12) <br /> 29 CCR 2643(e) Biennial tightness test of gravity piping(pre-JanuM 1, 1984) <br /> 30 CCR 2643(d) Triennial line test for conventional suction Pi2inE(pre-January 1, 1984) (MI) <br /> 31 HSC 25292.5 Double wall system located within 1000'2Lublic well-ELD <br /> 32 CCR 2661 Permit to re air UST systern <br /> 33 HSC 25286(a) Permit to alter monitoring system <br /> 34 HSC 25298(b) Permit to temporarily close UST system <br /> 35 HSC 25298(c) Permit to close UST system <br /> 36 HSC 25299(a)19) Disabling leak detection devices <br /> 37 1 HSC 25298(a) Illegal abandonment of UST system <br /> —38--F <br /> EHD INSPECTOR: PHONE: UIC <br /> Se <br /> atic system <br /> -Serves�!20 people/day <br /> RECEIVED BY: TITLE: -Receives other than sanitary waste <br /> Other disposal methods: <br /> Dry wells/French Drains <br /> EHD 23-02-002 REV 05/07 <br />