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• VI'se aras�-eV6e,I1!• Vvveea a r,,K�+, <br /> • NViRONMENTAL HEALTH DEPAR NT PAGE \ ov a. <br /> • 04 E.Weber Ave.,Third Floor.Stockton,CA 95202 <br /> (209)468-3420 <br /> UNDERGROUND STORAGE TANK(UST)PROGRAM INSPECTION REPORT <br /> Facility Name Cis Facility Address v\cctxt �+►a;7 <br /> Facilty Contact SNwN s\aGy► Title Phone#6^-®"VSPa <br /> USTO a Product UST#•Product 0A UST#q Product %-- UST#�__P.roduct_______ <br /> Overfill Prevention: O AudibleNi al tii(Mechanical Monitoring Panel: - 3 <br /> Piping System: 0 Gravity if Pressure 0 Suction // Violations: Er Inor 0 Major <br /> Automatic Pump Shut D wn Satisfies CCR 2636 : 84as 0 No Dis enser Pan: Pies O No <br /> INSPECTION TYPE': MAoutine ®Monitoring Certification OComplaint Olnstail ORemoval ORepair/upgrade <br /> COMPANY NAME: TECHNICIAN NAME: PHONE: <br /> VIOLATION(S) <br /> The above facility is not in compliance with the following section(s)of Health &Safety Code (HSC)and/or <br /> California Code of Regulations (CCR): <br /> • 1 HSC 25284 Permit to operate 20�CCR 2712(b) Maintenance&monitoring <br /> 2 CCR 2637 Secondary cont testing(6 records <br /> month/36 month) •21�CCR 2636(f)(4) Annual line tightness test(c) Current State Forms A&B 22 CCR 2630(d) Annuai,line leak detector test <br /> 3�CCR 2711(b)& <br /> 4 HSC 25292.2 Certification of financial , 23_�7CCR 2630(d) Annual monitoring certification <br /> responsibility and letter from 24 CCR 2643(d) Daily monitoring,of sugpon <br /> chief financial officer piping that is not continuously <br /> 5 CCR 2630(d) Continuous monitoring system monitored <br /> for UST system 25 CCR 2636(a) Conventional suc4on piping <br /> 6 CCR 2636(c)(1) All releases in secondary piping shall have continuous <br /> flow to a collection sump monitoring&2°•p9ntainment <br /> 7 HSC 25291 (e) Water in secondary(2®)cont 26 CCR 2643(e) Biennial tightness test of.graviq <br /> 8 NSC 25291 (f) Automatic line leak detector(s) piping that is not continuously <br /> 9 CCR 2636(f)(1) Continuous monitoring system monitored <br /> for underground piping 27 CCR 2662 Upgrade requirements for UST <br /> 10 CCR 2632 (c)(2) Continuous monitoring system system <br /> for UST 28 CCR 2661 Permit to repair UST system <br /> 11 HSC 25291(a)(2) Secondary containment for 29 HSC 25286(a) Permit to after monitoring <br /> UST is tight system <br /> 12 CCR 2636(f)(1) Continuous monitoring system 30 HSC 25298(a) Illegal abandonment of UST <br /> for dispenser system system <br /> 13 CCR 2635(b)(1) • ,Spill container 31 HSC 25298(b) Permit to temporarily close US <br /> 14 CCR 2635(b)(2) ADverfill prevention system system <br /> 15 CCR 2631 (a) Primary containment Is product- 32 HSC 25298(c) Permit to close UST system <br /> tight 33 HSC 25291 (e) Water in 20 cont analyzed and <br /> 16 HSC 25292.1 UST system Is operated to properly disposed of <br /> prevent unauthorized release 34 CCR 2640(e) Single wall,component within <br /> 17 CCR 2650 Recording/reporting 1000°of Pubilc Well, no ELD <br /> unauthorized release 35 CCR 2635(a)(2)(A)Cathodic protection testing <br /> 18 CCR 2632(d) Monitoring&response plan 36 H&SC 25299(a)(9)Disabling teak detect.devices <br /> 19 CCR 2712(1) Monitoring&response plan is 37 Violation(s)not listed above <br /> on site <br /> EHD INSPECT PHONE: %0�6- I:Ab'1 <br /> RECEIVED BY: AWIZ ,•=•TITLE: ' / <br /> unm1WVNW maox� <br />