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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.sjgoy.org/eh <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Facility name: Designated Operator: Inspection Date: <br /> 7 <br /> Facility address: UST# <br /> 571 - <br /> Product 97 <br /> FacilityContact: Title: Phone: <br /> Monitoring n: Overfill prevention: <br /> Vf?—I I El Suction El Graxit echanical El Audible/visual <br /> Inspection type: Violations: <br /> Routine �Monitoring Certification El Installation El Other: El M I-RDetect El M2-RPrev 0 M-3 Both <br /> T <br /> VIOLATION(S) HSC=Califomia Health&Safety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section V=Violation;RV=Repeat Violation V <br /> I HSC 25284 Permit too2erate <br /> 2 CCR 2637 Seconds a containment test performed <br /> 3 CCR 2711 (b)&(c) Current Unified Proram Consolidated Forms on file with EHD lFacility and tank form) <br /> 4 HSC 25292.2 Certification of financial res2onsibilitz and CFO letter <br /> 5 CCR 2632(b) Monitoring Proram MonitorinE&Res once Plan)is current and approved by the local agenc <br /> 6 CCR 2712(i) Monitorina 21an is onsite. <br /> 7 CCR 2712 lbMaintenance&monitoring records <br /> 8 CCR 2643(d) Dail X monitoring of Suction piping(pre-Janus!-I, 1, 1984) <br /> 9 HSC 25292.1 UST system iso2erated to revent unauthorized release <br /> 10 1 CCR 2632(c)(2) UST monitorinsystem is present (M1) <br /> I I CCR 2630(d) UST system monitoring equi2ment is 2ro2erly located to detect a leak (M1) <br /> 12 HSC 25291 (b) UST system monitorinequipment iso2crational (M2) <br /> 13 CCR 2636(D(IContinuous monitorinE system for under round piping&UDC is present (M1) <br /> 14 CCR 2631 a) Primary containment is product tight <br /> 15 HSC 25291 a) 2) Secondary containment for UST is ti ht <br /> 16 CCR 2636(c)l I) All releases in seconds ly Riping flow to a collection sump <br /> 17 HSC 25291 ID Line leak detectors are installed (MI) <br /> 18 CCR 2635(b)(1) Spill container (M2) <br /> 19 CCR 2635 lb)(2Overfill prevention system (M2) <br /> 20 CCR 2636(a) Conventional suction 2i2inE shall have continuous monitoring&2'containment <br /> -TI HSC 25291 (e) Water in 2'containment analyzed&Rro2erly disposed of <br /> 22 CCR 2650 Recordin /reporting of unauthorized releasesI------- (M 1) <br /> 23 CCR 2715 Desi hated 02erator:(a)Statement from UST owner; (c-e)Monthly ins pectionk(f) Employee trainin-h W <br /> 24 CCR 2638(a) Annual monitorina certification —A <br /> 25 CCR 2638(a) Annual line leak detector test (Ml)_ <br /> 26 HSC 25284.2 Annual spill containment testing <br /> 27 CCR 2636(f)(4) Annual line tightness test (M 1) <br /> 28 CCR 2661 (f) Repair for tank/pining has had tiht (M2) <br /> 29 CCR 2643(e) Biennial tightness test of gravity Eiping(pre-Janus a 1, 1984) <br /> 30 CCR 2643(d) Triennial line test for conventional suctiongj2ji2nj.(( re-Janus 1, 1984) (M 1) <br /> 31 HSC 25292.5 Double wall system located within 1000'of public well-ELD <br /> 32 CCR 2661 Permit to repair UST system <br /> 33 HSC 25286(a) Permit to alter monitorinR system <br /> 34 HSC 25298(b) Permit to tem2orarily close UST system <br /> 35 HSC 25298(c) Permit to close UST system <br /> 36 HSC 25299(a)(9) Disabling leak detection devices <br /> 37 HSC 25298(a) Illegal abandonment of UST system <br /> 38 Other: <br /> EHD INSPECTOR: PHONE: UIC <br /> Seatic system <br /> Serves 2:20 people/day <br /> RECEIVED BY TITLE: Receives other than sanitary waste <br /> Other disposal methods <br /> Dry wells/French Drains <br /> EHD 23-02-002 REV 05/07 <br />