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aSAN 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/eIld <br />UNDERGROUND STORAGE TANK JUST) PROGRAM INSPECTION REPORT <br />Facility name: Designated Operator: Inspection Date: <br />A 41 (' 14 aff � <br />Facility address: <br />Lo (A I X- <br />ON j0g±?TVi5-A <br />UST # <br />Product <br />Facility Contact: <br />Title! Phone: <br />--T <br />Monitoring Panel: <br />6aqg(A <br />Piping system: <br />Vpressurized 11 Suction 11 Gravity <br />Overfill prevention: <br />I mechanical 11 Audible/visual <br />Inspection type: <br />Vk.utine U4onitoring <br /># Code Section <br />Violations. <br />Certification 11 Installation 0 Other: E M I -RDetect [I M2-RPrev 0 M-3 Both 1 <br />_, R <br />VIOLATION(S) HSC=Califomia Health & Safety Code; CCR=Califomia Code of Regulations V VR <br />V] <br />V=Violation; RV=REpeat Violation V <br />I <br />HSC 25284 <br />Permit tooperate <br />2 <br />CCR 2637 <br />Secondcontainment test 2erformed <br />M <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 res2onsibilitz and CFO letter <br />5 <br />CCR 2632 (b) <br />Monitoring Proram (Monitoring & Res2onse Plan) is current and ap2roved by the local aaenc y. <br />6 <br />CCR 2712 �i) <br />Monitoring plan is onsite. <br />7 <br />CCR 2712 (b) <br />Maintenance & monitoring records (M 1) <br />8 <br />CCR 2643 (d) <br />Daily monitoring of suction piping (pre -Janna! -I, 1, 1984) <br />9 <br />1 HSC 25292.1 <br />UST system iso2erated to prevent unauthorized release <br />I <br />CCR 2632 (c)(2) <br />UST monitoring system is present (M1) <br />11 <br />CCR 2630 �d) <br />UST system monitorinE equiEment is properly located to detect a leak 1) <br />12 <br />HSC 25291 �b) <br />UST system monitoring equipment iso2erational (M2) <br />13 <br />CCR 2636 (n(I <br />Continuous monitorinE system for under round 2i2ina & UDC is 2resent <br />14 <br />CCR 2631 �a) <br />Primary containment is product ti �Yht <br />15 <br />1 HSC 25291 �a)Q <br />Secondary containment for UST is ti ht <br />16 <br />CCR 2636 c) 1) <br />All releases in seconds Ly piping flow to a collection sum2 <br />17 <br />HSC 25291 <br />Line leak detectors ) are installed (M 1) <br />18 <br />CCR 2635 b)(I) <br />Spill container (M2) <br />19 <br />CCR 2635 b)(2) <br />Overfill prevention system (M2) <br />20 <br />CCR 2636 (a) <br />Conventional suction Ri2inE shall have continuous monitorin& 2' containment <br />21 <br />HSC 25291 (e) <br />Water in 2' containment analyzed & Ero2erly disposed of <br />22 <br />CCR 2650 <br />Recordin/reporting of unauthorized releases (M1) <br />23 <br />1 CCR 2715 <br />Desinated Oj2erator: (a) Statement from UST owner; (c -e) Monthlinsctiol ainin� <br />24 <br />1 CCR 2638 a) <br />Annual monitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test (M 1) <br />26 <br />HSC 25284.2 <br />Annual s2ill containment testing <br />27 <br />CCR 2636 4) <br />Annual line tightness test MI) <br />28 <br />CCR 2661 <br />E2eair for tank/ pi2inE has had tihtness test (M2) <br />29 <br />CCR 2643 (e) <br />Biennial tightness test of gravity piping re=Janus 1, 1984) <br />30 <br />1 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 2ublic well-ELD <br />32 <br />CCR 2661 <br />Pen -nit to Mair UST system <br />33 <br />HSC 25286 (a) <br />Permit to alter monitorinE system <br />34 <br />HSC 25298 (b) <br />Permit to tem2orarily 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 />Illeaal abandonment of UST system <br />38 Other: I <br />EHD INSPECTOR: PHONE: <br />KA <br />3; <br />UIC <br />Septic systen. <br />Serves �!20 people/day <br />Receives other than sanitary waste <br />Other disposal methods: <br />I- = wells/French Drains ---j <br />RECEIVED BY: <br />(� <br />--- 7— <br />TITLE: <br />EHD 23-02-002 REV 05/07 <br />