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SAN JOAQUIN COUNTY . DATE <br />PR# <br />E VIRONMENTAL HEALTH DEPARTMENT PAGE <br />304 E. Weber Ave., Third Floor, Stockton, CA 95202 <br />(209) 468-3420 <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility Name6 ) -,W, "l (I Facility Address Ts ,S. -7—g _ ,V r`,rfj T <br />Facilty Contact��� Z,6,A ( Title &W, Phone # <br />UST# -L- Product_ UST#JJProductfty UST# Product UST# Product <br />Overfill Prevention: ❑ AudibleNisyyal ❑ Mechanical Monitoring Panel: S-3� <br />Piping System: ❑ Gravity 7essure ❑ Suction Violations:linor ❑ Major <br />Automatic Pump Shut Down Satisfies CCR 2636 (g): ❑ Yes ❑ No Dispenser Pan: Yes ❑ No <br />INSPECTION TYPE: <br />COMPANY NAME: <br />utine ❑Monitoring Certification ❑Complaint ❑Install ❑Removal ❑Repair/Upgrade <br />TECHNICIAN NAME: <br />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 <br />HSC 25284 <br />Permit to operate <br />20 <br />V CCR 2712 (b) <br />Maintenance & monitoring <br />2 <br />CCR 2637 <br />Secondary cont testing (6 <br />records <br />month/36 month) <br />21 <br />CCR 2636 (f)(4) <br />Annual line tightness test <br />3 <br />CCR 2711(b) & (c) <br />Current State Forms A & B <br />22 <br />CCR 2630 (d) <br />Annual line leak detector test <br />4 <br />HSC 25292.2 <br />Certification of financial <br />23 <br />CCR 2630 (d) <br />Annual monitoring certification <br />responsibility and letter from <br />24 <br />CCR 2643 (d) <br />Daily monitoring of suction <br />chief financial officer <br />piping that is not continuously <br />5 <br />CCR 2630 (d) <br />Continuous monitoring system <br />monitored <br />for UST system <br />25 <br />CCR 2636 (a) <br />Conventional suction piping <br />6 <br />CCR 2636 (c)(1) <br />All releases in secondary piping <br />shall have continuous <br />flow to a collection sump <br />monitoring & 20 containment <br />7 <br />HSC 25291 (e) <br />Water in secondary (20) cont <br />26 <br />CCR 2643 (e) <br />Biennial tightness test of gravit, <br />8 <br />HSC 25291 (f) <br />Automatic line leak detector(s) <br />piping that is not continuously <br />9 <br />CCR 2636 (f)(1) <br />Continuous monitoring system <br />monitored <br />for underground piping <br />27 <br />CCR 2662 <br />Upgrade requirements for UST <br />10 <br />CCR 2632 (c)(2) <br />Continuous monitoring system <br />system <br />for UST <br />28 <br />CCR 2661 <br />Permit to repair UST system <br />11 <br />HSC 25291(a)(2) <br />Secondary containment for <br />29 <br />HSC 25286 (a) <br />Permit to alter monitoring <br />UST is tight <br />system <br />12 <br />CCR 2636 (f)(1) <br />Continuous monitoring system <br />30 <br />HSC 25298 (a) <br />Illegal abandonment of UST <br />for dispenser system <br />system <br />13 <br />CCR 2635 (b)(1) <br />Spill container <br />31 <br />HSC 25298 (b) <br />Permit to temporarily close US" <br />14 <br />CCR 2635 (b)(2) <br />Overfill prevention system <br />system <br />15 <br />CCR 2631 (a) <br />Primary containment is product- <br />32 <br />HSC 25298 (c) <br />Permit to close UST system <br />tight <br />33 <br />HSC 25291 (e) <br />Water in 2° cont analyzed and <br />16 <br />HSC 25292.1 <br />UST system is operated to <br />properly disposed of <br />prevent unauthorized release <br />34 <br />CCR 2640 (e) <br />Single wall component within <br />17 <br />CCR 2650 <br />Recording/reporting <br />1000' of Public Well, no ELD <br />unauthorized release <br />35 <br />CCR 2635(a)(2)(A) Cathodic protection testing <br />18 CCR 2632 (d) <br />Monitoring & response plan <br />36 <br />H&SC 25299(a)(9) Disabling leak detect. devices <br />19 <br />CCR 2712 (i) <br />Monitoring & response plan is <br />37 <br />Violation(s) not listed above <br />on site <br />Of <br />EHD INSPECTO <br />L A Z <br />PHONE: 414�%eo- <br />RECEIVED BY: <br />—7 <br />TITLE: <br />UNITIIUUST/INSP (rev 724/02) <br />