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R U p M\ <br /> SAN JOA UIN COUNTY <br /> G <br /> <� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> UNDERGROUND STORAE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: [Ds,,nated Operator: Inspection Date: <br /> Ir Y; 1� 1101 <br /> Facility address: # t,®{roduct l e <br /> Facility ontact: Title: ( Phone: <br /> Yi o <br /> Mollitorihg Panel: Piping system: Overfill prevention: <br /> Pressurized ❑Suction ❑Gravit _ Mechanical ❑Audible/visual <br /> [Inspection type: Violations: <br /> 11 Routine MonitoringCertification ❑Installation ❑Other: M1-RDetect ❑M2-RPrev ❑M-3 Both <br /> VI LATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section V <br /> V=Violation;RV=Re eat Violation <br /> 1 HSC 25284 Permit tooperate <br /> 2 CCR 2637 Secondary containment test performed <br /> 3 CCR 2711 b)& c) Current 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(c)(2)(D) Monitorin &response plan is current and filed with the local a enc <br /> 6 CCR 2712 i Monitorin &response plan is onsite <br /> 7 CCR 2712(b) Maintenance&monitoring records (MI) <br /> 8 CCR 2643 d Daily monitoring of suction piping(pre-January, 1, 1984) <br /> 9 HSC 25292.1 UST system isoperated to prevent unauthorized release <br /> 10 CCR 2632 c 2 UST monitoring system is resent Ml <br /> 11 CCR 2630(d) REEF <br /> monitorin a ui ment is ro erl located to detect a leak ( l) <br /> 12 HSC 25291 b monitorin a ui ment iso erational (M2 <br /> 13 CCR 2636 1)(1) monitorin s stem for under round i in &UDC is resent (MI) <br /> 14 CCR 2631 a tainment is roduct ti ht15 HSC 25291 (a(2) ontainment for UST is ti ht16 CCR 2636 c 1 in seconda i in flow to a collection sum <br /> 17 HSC 25291 f) Line leak detector(s)are installed (Ml) <br /> 18 CCR 2635(b)(1) Spill container M2 <br /> 19 CCR 2635(b)(2) Overfill 2revention system (M2) <br /> 20 CCR 2636(a) Conventional suction pipinE shall have continuous monitoring&2°containment <br /> 21 HSC 25291 (e) Water in 2°containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases 1 <br /> 23 CCR 2715 Designated Operator:(a)Statement from UST owner; (c-e)Monthly inspection;(f)Employee training <br /> 24 CCR 2638(a) Annual monitoring certification <br /> 25 CCR 2638(a) Annual line leak detector test (Ml) <br /> 26 HSC 25284.2 Annuals ill containment testin <br /> 27 CCR 2636(f)(4) Annual line tightness test (Ml) <br /> 28 CCR 2661 Repair for tank/piping has had tijahtness test 2 <br /> 29 CCR 2643(e) Biennial tightness test of gravity piping( re-Januar 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction pipinre-Januaa1, 1984 Ml <br /> 31 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 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)(9) DisablinE leak detection devices <br /> 37 HSC 25298 a) Illegal abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> C Septic system: <br /> ® ❑Serves>_20 people/day <br /> R CEIV D BY TITLE: ❑Receives other than sanitary waste <br /> Otherdisposal methods: <br /> ❑Dry wells/French Drains <br /> EHD 23-02 <br /> 1/1/07 <br />