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.Vk <br />• SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <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 />Designated Operator: <br />Inspection Date: <br />Facility address: --� ` t,� —�y�, <br />K"K� �'v V. ` v— `�- i Ck.` <br />UST # <br />Product <br />01 <br />Facility Contact: <br />Title: Phone: <br />M nitoring Panel: <br />J (Z S` J <br />Pip' system: <br />Pressurized D Suction ❑ Gravity <br />O ll prevention: <br />echanical ❑ Audible/visual <br />Ins ection type: <br />Routine onitoring Certification El Installation El Other: <br />Violations: <br />F1M1-RDetect <br />11M2-RPrev F1 M-3 Both <br /># Code Section <br />VIOLATION(S) HSC=Califomia Health & Safety Code; CCR=Califomia Code of Regulations V R <br />V=Violation; RV=Re eat Violation V <br />1 HSC 25284 <br />Permit tooperate <br />2 CCR 2637 <br />Secondary containment test performed <br />3 CCR 2711 b & c <br />Current Unified Program Consolidated Forms on file with EHD (Facility and tank form <br />4 1 HSC 25292.2 <br />Certification of financial responsibility and CFO letter <br />5 CCR 2632 c 2 D <br />Monitoring & response plan is current and filed with the local agency <br />6 CCR 2712 i <br />Monitoring & response plan is onsite <br />7 CCR 2712 b <br />Maintenance & monitoring records <br />M1 <br />8 CCR 2643 d <br />Daily monitoring of suction piping (pre -January, 1, 1984 <br />9 HSC 25292.1 <br />UST system isoperated to prevent unauthorized release <br />10 CCR 2632 (c)(2) <br />UST monitoring system is present <br />Ml <br />11 CCR 2630 d <br />UST system monitoring equipment is properly located to detect a leak <br />Ml <br />12 HSC 25291 <br />UST system monitoring equipment isoperational <br />M2 <br />13 CCR 2636 1 <br />Continuous monitoring system for underground piping & UDC is present <br />M1 <br />14 CCR 2631 a <br />Primary containment is product tight <br />15 HSC 25291 (a)(2) <br />Secondary containment for UST is tight <br />16 CCR 2636 (cX]) <br />All releases insecond i in flow to a collection sump <br />17 HSC 25291 <br />Line leak detectors are installed <br />Ml <br />18 CCR 2635 (b)(1) <br />Spill container <br />(M2 <br />19 CCR 2635 (b)(2) <br />Overfill prevention system <br />M2 <br />20 CCR 2636 (a) <br />Conventional suction piping shall have continuous monitoring & 2° containment <br />21 HSC 25291 (e) <br />Water in 2° containment analyzed & properly disposed of <br />22 1 CCR 2650 <br />Recording/reporting of unauthorized releases <br />Ml _ <br />23 CCR 2715 <br />Designated Operator: (a) Statement from UST owner; (c -e) Monthly inspection; f) Employee training <br />24` CCR 2638 a <br />Annualmonitoring certification <br />25 CCR 2638 (a) <br />Annual line leak detector test <br />MI <br />26 HSC 25284.2 <br />Annual spill containment testing <br />27 CCR 2636 4 <br />Annual line tightness test <br />MI <br />28 1 CCR 2661 (f) <br />Repair for tank/piping has had tightness test <br />(M2 <br />29 CCR 2643 e <br />Biennial tightness test of gravity piping(pre-January 1, 1984 <br />30 CCR 2643 (d) <br />Triennial line test for conventional suction piping (pre-January1, 1984 <br />MI <br />31 HSC 25292.5 <br />Double walls stem located within 1000' of public well-ELD <br />32 CCR 2661 <br />Permit to repair UST system <br />33 HSC 25286 a <br />Permit to alter monitoring system <br />34 1 HSC 25298 <br />Permit to temporarily close UST system <br />35 HSC 25298 c <br />Permit to close UST system <br />36 HSC 25299 (a)(9) <br />Disabling leak detection devices <br />37 HSC 25298 a) <br />Illegal abandonment of UST system <br />38 Other: <br />EHD INSPECTOR: <br />O ,Ghq�]�iAF_' <br />PHONE: UIC <br />c30o ?�\\c�� Septic system: <br />Serves >_20 people/day <br />TITLE: Receives other than sanitary waste <br />Other disposal methods: <br />Dry wells/French Drains <br />RECEIVED BY: <br />EHD 23-02-002 <br />