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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.sjgov.org/ehd. <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> Facility address: UST 4 7 <br /> Product <br /> Facility Contact: Title: 71 <br /> Phone: <br /> Pjree_� <br /> M nitoringPanel: Piping system: Overfill prevention: <br /> �iessurjzecl El Suction El Gravity echani�cal El Audible/visual <br /> Inspection type: Violations: <br /> Routine VMonitoring Certification ❑installation El Other: 0 M I-RDetect El M2-RPrev 11. -3 Both <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=California Code of Regulations V R <br /> # Code Section V <br /> V=Violation; RV=R22eat Violation <br /> I HSC 25284 Permit too2erate <br /> 2 CCR 2637 SecondM containment test 2erformed <br /> 13 CCR 2711 b)&(eCurrent Unified Program Consolidated Forms on file with EHD Facility and tank form) <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632(b) Monitoring Program(Monitorin &Res onse Plan)is current and approved by the local aEenc <br /> 6 CCR 2712(i) MonitorinE 21an is onsite. <br /> 7 CCR 2712 bMaintenance&monitorinrecords (M 1) <br /> 8 CCR 2643(d) Daily monitoring of suction 2i2ing(pre-Januaa, 1, 1984) <br /> 9 HSC 25292.1 USTstem iso2erated to revent unauthorized release <br /> 10 CCR 2632 c)(2) UST monitorinE system is present (M 1) <br /> I I CCR 2630(d) UST system monitoring equipment is properly located to detect a leak (M 1) <br /> 12 HSC 25291 b) UST system monitormE e ui ent isoperational (M2) <br /> 13 CCR 2636 1) Continuous momLo�;t�emfor under i in &UDC is 2resent (M 1) <br /> 14 CCR 2631 a) Primary containment is 2roduct ti aht <br /> 15 HSC 25291 (a)j2) SecondaEZ containment for UST is tiht <br /> 16 CCR 2636 c)(I) All releases in secondaa 2ipinE flow to a collection sum2 <br /> 17 HSC 25291 Line leak detector(s)are installed (Ml) <br /> 18 CCR 2635 b)(I) S2ill container (M2) <br /> 19 CCR 2635(b)(2) Overfill prevention system (M2) <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitorin containment <br /> 21 HSC 25291 (e) Water in 2'containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/re portinof unauthorized releases (M1) <br /> 23 CCR 2715 Designated 02erator:(a)Statement from UST owner; (c-e)Monthly ins2ection;(t)Em2loyee trainin� <br /> 24 CCR 2638 a) Annual monitoring certification <br /> 25 1 CCR 2638(a) Annual line leak detector test (M1) <br /> 26 HSC 25284.2 Annuals ill containment testinE <br /> 27 CCR 2636 4) Annual line tightness test (M1) <br /> 28 CCR 2661 (f) Repair for tank/piping has had tiEhtness test (M2) <br /> 29 CCR 2643(e) Biennial tightness test of gravity piping(pre-January 1, 1984) <br /> 30 CCR 2643(d) Triennial line test for conventional suction 2i2in ( re-Januaix 1, 1984) (M1) <br /> 31 1 HSC 25292.5 Double walls stem located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286(a) Permit to alter monitorinE 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)(9) DisablinE leak detection devices <br /> 37 1 HSC 25298(a) IlleEal abandonment of UST system <br /> 38 1 Other: <br /> EHD INSPECTOR: PHONE- UIC <br /> Se <br /> otic <br /> -Serves>20 people/day <br /> WjVF V <br /> RECEILVED)3y: TITLE: -Receives other than sanitary waste <br /> Other disposal methods: <br /> Dry wells/French Drains <br /> EHD 23-02-002 REV 05/07 <br />