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Q V1�1� v • SAN JOAQUIN COUNTY �I <br /> ENVIRONMENTAL HEALTH DEPARTMENT� �� 304 East Weber Avenue,3rd Floor,Stockton,CA 95202-2 P08 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.s' 'v.or ehd <br /> UNDERGROUND STORAGE TANK ST PROGRAM INSP CTION REPORT <br /> Facility name: Deal g ated Operator: Inspection Date: <br /> i'/ <br /> Facility address: UST$ <br /> Product '1 <br /> Facility Contact: Title: Phone: <br /> M <br /> on'orin Panel:1,rte Piping system:7Over ill prevention: <br /> 7� PEl Suction GravityLl Over <br /> Audible/visual <br /> In ection type: Viola ions: <br /> Routine Monitoring Certification Ll Installation 11 other ❑Ml RDetect ❑M2-RPrev ❑M-3 Both <br /> # Code Section <br /> VIOLATIONS) HSC=California Health&Safety Code;CCR=Cal fomia Code of Regulations V R V=Violation;RV=Re eat Violation V <br /> I HSC 25284 Permit tooperate <br /> 2 . . .CCR 2637 'Secondary containment test performed <br /> 3 CCR 2711 b & c Current Unified Pro am Consolidated Forms on file with EHD Facilit a d tank form <br /> 4 HSC 25292.2 Certification of financial responsibility and CFO letter <br /> 5 CCR 2632 c 2(D) Monitoring&response plan is current and filed with the local agency <br /> 6 CCR 2712'i Monitoring&.response plan is onsite <br /> 7 CCR 2712 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 Present Ml <br /> 11 CCR 2630 itUST system monitoring equipment is properly located to detect a leak Ml <br /> 12 HSC 25291'- UST system monitoring equipment isoperational M2) <br /> 13 CCR 2636 (I) Continuous monitoring system for underground piping&CDC is present Ml <br /> 14 CCR 2631 a Primary containment is product tight - <br /> 15 HSC 25291 (a)(2) Secondary containment for UST is tight <br /> 16 CCR 2636(c)(1) All releases in secondary pipingflow to a collection sum <br /> 17 HSC 25291 Line leak detectors are installed M1 <br /> 18 CCR 2635 1). Spill p container (M2 <br /> 19 CCR 2635(b)(2) Overfill prevention system M2 <br /> 20 CCR 2636(a) Conventional suction piping shall have continuous monitoring&20 containment <br /> 21 HSC 25291 (e) Water in 20 containment analyzed&properly disposed of <br /> 22 CCR 2650 Recording/reporting of unauthorized releases MI <br /> 23 CCR 2715 Designated Operator: a Statement from UST owner; (c-e)Kionthly inspection;( Employee training <br /> 241 CCR 2638 (a Annual monitorin certification <br /> 25 CCR 2638 a) Annual line leak detector test MI <br /> 26 HSC.25284.2 .Annuals ill containment testing <br /> 27 CCR 2636 4 Annual line tightness test Ml <br /> 28 CCR 2661 (f) Repair for tank/piping hasp had tightness mess test (M2 <br /> 29 CCR 2643 a Biennial tightness test of gravity pipingre-Janus 1, 1984 <br /> 30 CCR 2643 d Triennial line test for conventional suction ppiping( re-Jana 1,1984) (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 Permit to temporarily close UST system <br /> 35 HSC 25298(c' <br /> c Permit to close UST system <br /> 36 HSC 25299(a(9 Disablin leak detection devices <br /> 37 HSC 25298 a Ille al abandonment of UST system <br /> 38 Other: <br /> EHD SPECTOR: PHONE: UIC <br /> WZmay) p�h Septic stem: <br /> %/ erves 210 people/day <br /> RECEIVED BY: TITLE: ❑Receives other than sanitary waste <br /> Other Drywalmetench <br /> )'( /V7rr. 1'( .�h wells/French Drains <br /> EHD 23-02-0021.4 <br />