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9171 9690 0935 0118 0993 44 <br /> San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California 95206-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 468-3433 Web:www.s4goy.org/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Phone: Date: <br /> VAN DE POL ENTERPRISES INC (209)466-5921 January 31, 2017 <br /> Facility Address: CERS ID: <br /> 816 E FRONTAGE RD RIPON, CA 95366 10181513 <br /> Inspection Contact: Title: Phone: <br /> Ted Shackelford Operator (209) 649-8308 <br /> Inspection Type: Program: <br /> ROUTINE INSPECTION - Operating Permit 2361 - UST FACILITY <br /> Consent For: I Consent Given By: <br /> CI Inspection Z Photos 0 Samples I Ted Shackelford, Operator <br /> Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: <br /> Dave Winkler 03/01/2018 Felix Ramirez 02/26/2018 <br /> Service Technician Manufacturer's Training <br /> VMI, 11112117; VR. 02103118, TT,03/31/17 <br /> alp emia 77 7 P.eguTations HSC=Realth and SafetyGode CFR=Code oTFederal Regulations <br /> V=Violation R=Repeat violation COS=Corrected on site during inspection <br /> File Review <br /> 101 1 HSC 25284 No permit to operate o V ❑R ❑COS <br /> 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system o V n R ❑COS <br /> 103 'HSC 25292.2 Current financial responsibility documents not submitted ❑V ❑R e COS <br /> 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current ■V w R ❑COS <br /> 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan ■V ■R ❑COS <br /> 106 CCR 2632(4)(2) Failed to have an approved UST response plan ❑V ❑R n COS <br /> 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed ei V e R o COS <br /> 108 CCR 2637(f),2638(e) Failed to notify the EHD 48 hours prior to conducting testing u V ❑R ❑COS <br /> 109 CCR 2637 Failed to test secondary containment in V ❑R ❑COS <br /> 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days ❑V ©R ❑COS <br /> 111 CCR 2638(x) Failed to test monitoring and leak detection equipment annually ❑V n R ❑COS <br /> 112 HSC 25284.2 Failed to test spill containers annually ❑V o R ❑COS <br /> 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days o V ❑R ❑COS <br /> 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down n V o R ❑COS <br /> 115 CCR 2715(x) Failed to inform the EHD of designated operator identification or change within 30 days ©V Ei R ❑COS <br /> 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification ❑V ❑R n COS <br /> 117 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after ❑V ❑R o COS <br /> 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑V ❑R o COS <br /> 119 HSC 25299 Documents were falsified or misrepresented ❑V ❑R ❑COS <br /> 120 CCR 2635(d) Failed to submit UST Certification of InstallationfModification ❑V ❑R ©COS <br /> 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ❑V e R o COS <br /> 122 CCR 2631 a) Failure to submit UST system component statement of compatibility for substance stored ❑V ❑R COS <br /> On Site Records <br /> 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions ❑V R COS <br /> 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 112 years a V ❑R n COS <br /> 203 CCR 2712(b) Failed to maintain records of monitoring, repair,lining,and upgrades on site ❑V ❑R u COS <br /> FA0003911 PR0231470 SCO01 01131/2017 <br /> EHD 23-01 Rev.09/22/16 Pagel of 6 Underground Storage Tank Program OdR <br />