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T Stanishaus County DEPARTMENT OF ENVIRONMENTAL RESOURCES' RCES Hazardouswterials <br /> Depaitrnent <br /> of Phone: <br /> Ennihronntnental Resources INSPECTION REPORT FFa)c (2t9)525 -6n4 <br /> j 3800 Cornucopia Way,Suite C CALIFO I FETY CODE <br /> I Modesto,CA 95358 CALIFORNIA CODE OF REGULATIONS <br /> Facility: A L. . e Upgrade Cert#16W-1t% Date: <br /> 4ddress: L� Z 61A, a f L' Permit#/Exp: <br /> Inspection: ( )Initial Annual/Biennial ( )Recheck ( )Permit ( )Release <br /> HAZARDOUS MATERIALS DISCLOSURE PROGRAM <br /> -fes No Business Activities Form (Sections CCR 2729.2) <br /> _ Completed business activities form. (renewal date ) <br /> Business Information (Sections 25504 CCR 2729,2731) <br /> _ Business owner/operator identification form complete and accurate. <br /> Response Plan Information (Sections 25504,25505,CCR 2731,2732) <br /> _ Emergency response plans and procedures complete,emergency coordinator information accurate. <br /> Mitigation, prevention,and abatement of hazards-written procedures. <br /> Employee training program documented: initial and annual refresher. <br /> Business plan certified by appropriate person. <br /> Inventory Information (Sections 25505,25509,25509.3,CCR 2729) <br /> Chemical inventory&chemical description is accurate and complete. <br /> _ Treatment,disposal, and waste codes reported. <br /> SttelBuildin Ma (Sections 25504, CCR 2729,2730,2731) <br /> rte ui Ming <br /> map is complete and identifies all required areas. <br /> Above round Storage Tank (Sections 25270.5(c) ) <br /> _ an c capaaty> 60 gal or total capacity> 1320 gal. (SPCC required-date completed_) <br /> UNDERGROUND STORAGE TANK PROGRAM <br /> Yes No Owner/O erator Contract Yes No Double Wall Tanks <br /> _ acdity rm Dai a io wsua alarm check <br /> _ UST tanks form Dal Monitor) <br /> _ Financial cert. _ _ Daily visual check of monitoring system <br /> _ Release procedure Annual Re orts Tanks ISM DW) <br /> _ Written tank monitoring procedure an c tig tness test <br /> _ Certified dispensing meters _ _ Annular space cert. (DW) <br /> SIR _ _ Tank monitor(SW&DW) <br /> Daily tank and meter readings _ _ Sump Probe cert.(SW&DW) <br /> _ Biennial tank test(due ) _ _ Cathodic protection cert. (SW-date <br /> Lined Tanks (SW) Annual Reports,Pipelines (SW&DW) <br /> a is protection tested every 60 days _ _ ea c elector cert. <br /> _ Cathodic protection at 850mv or greater Pressurized line test <br /> Lining cert. (due_ _ _ Triennial suction line test(due_ <br /> Pipeline auto shutoff cert. <br /> OFFICIAL NOTICE <br /> ):, <br /> I 'i.corf /0C G%C <br /> 11K Af <br /> YOU ARE HE Y DI CTED TO CORRECT THE DEFICIENCIES LISTED ABOVE WITHIN 30 DAYS. <br /> INSPECTOR V 11 RECEIVED BY: Tt <br /> (Print) (sigrehjm) <br /> DER-71 <br />