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SAN JOAQUIN COUNTY <br />IRONMENTAL HEALTH DEPARTMENT <br />304 East eber Avenue, 3`a Floor, Stockton, CA 95202-10 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org//ehd <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility name: <br />roWa <br />Designated Operator: <br />Inspection Date: <br />o Facility address: <br />UST # <br />Product], <br />3 a 1 <br />s g <br />Facility Contact: <br />Title: Phone: <br />Monitoring Panel: y <br />�L& V <br />Piping system: <br />@fessurized ❑ Suction ❑ Gravity <br />Overfill prevention: <br />mechanical ❑ Audible/visual <br />7oInstype: <br />utine ❑ Monitoring <br />Certification ❑ Installation ❑ Other: <br />Violations: <br />❑ MI-RDetect ❑ M2-RPrev <br />❑ M-3 Both <br />a # <br />Code Section <br />VIOLATIONS) HSC=California Health & Safety Code; CCR=California Code of Regulations <br />V=Violation; RV=Re eat Violation <br />V R <br />V <br />1 <br />HSC 25284 <br />Permit tooperate <br />2' <br />CCR 2637 <br />Seconal' , containment test " erformed <br />3 <br />CCR 2711 b & c <br />Current Unified Program Consolidated Forms on file with EHD(Facility and tank form <br />4 <br />1 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 <br />Ml <br />8' <br />CCR 2643 d <br />Daily monitoring of suction piping rc-January, 1, 1984 <br />9 <br />HSC 25292.1 <br />UST system isoperated to prevent unauthorized release <br />10 <br />CCR 2632: <br />UST Monitoring tern is present <br />1 <br />I 1 <br />CCR 2630 d <br />UST system monitoring equipment is properly located to detect a leak <br />Ml <br />12 <br />HSC 25291: ;: <br />UST system monitoring equipment iso operational <br />M2 <br />13 <br />CCR 2636 1 <br />Continuous monitoring system for under round pi2ing & UDC is present <br />Ml <br />14 <br />CCR 2631 a <br />containment is product tight <br />15 <br />HSC 25291 (a)(2) <br />Secondary containment for UST is tight <br />16 <br />1 CCR 2636 (c)(1) <br />All releases in second ipirjg flow to a collection sum <br />17 <br />HSC 25291 <br />Line leak detectors are installed <br />Ml <br />1�8 <br />CCR 2635 !: 1 <br />Spill container <br />(M2 <br />19 <br />CCR 2635 (b)(2) <br />Overfill prevention system <br />M2 <br />20 <br />CCR 2636 (a) <br />Conventional suction i in :shall have continuous monitoring' & 20 containment <br />21 <br />HSC 25291 (e) <br />Water in 21 containment analyzed & properly disposed of <br />x 22 <br />1 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; Employee training <br />24 <br />CCR 2638;, a <br />Atnithillnonitoring certification <br />25 <br />CCR 2638 (a) <br />Annual line leak detector test <br />(Mi) <br />26 <br />HSC 25284.2 <br />Annuals ill containment testingu' <br />: 27 <br />CCR 2636 4 <br />Annual line tightness test <br />Ml <br />2$ <br />CCR 2661 (f) <br />Repair fbr;qqktoping has had tightness test <br />M2 <br />29 <br />CCR 2643 a <br />Biennial tightness test of gravity pipingre-Januar 1, 1984 <br />30 <br />CCR 2643 d <br />Triennial line test for conventional stiction piping in (pre -January 1, 1984)Mi <br />3l <br />HSC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <br />32 <br />CCR 2661 <br />Permit to repair LIST system <br />33 <br />HSC 25286 a <br />Permit to alter monitoring system <br />34 <br />HSC 25298 <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 />Ille al abandonment of UST s stem <br />38 <br />1 Other: <br />EHD INSPECTOR: <br />�✓� <br />PHONE: <br />K 6 — 3 q -a e <br />UIC <br />Septic system: <br />❑ Serves _>20 people/day <br />❑ Receives other than sanitary waste <br />Other disposal methods: <br />❑ Dry wells/French Drains <br />RECEIVED BY: <br />..�' <br />TITLE: <br />F14D 23-02-002 <br />