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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone.(209)468-3420 Fax.(209)468-3433 Web:www.sigov.org/ehd <br /> tJnde�irground�Stt�lrage Tank`Program S �� <br /> Facility Name: Facility Phone: Date: <br /> Lane (29 ifr4' V"4�'l� zA-r 231 - ��f iq ),7 <br /> Facility ress:. . <br /> 11afh�aeof <br /> Inspection on ac : title: one: <br /> Inspection ype: rogram: <br /> l au+irtc e7�7e)'d <br /> Co�ntent For: Consent Given y: +_ <br /> C'lnspection Ehotos l pies A, <br /> qo eu �J �Q <br /> Service ec nlcian nsite: Exp.date: DesignatedOperator: Exp. ate: <br /> Tun <br /> A <br /> Service ec nicianan ac urer s I raining: <br /> sec ;' f&Z 3 <br /> a i orma o e of FTegu—r5-ti3—n—s---R9T=HealLn and tiatety Code =Uccle of Fedoral Regulations 11 <br /> V=Uolatton R�Repeat violation COS=Corrected on site during inspection <br /> - t <br /> 101 HSC 25284 No permit to operate V-9 n R C COS <br /> 102 HSC 25284(x)(3) No written agreement between tank owner and tank operator to monitor the tank system C V ❑R ❑COS <br /> 103 HSC 25292.2 Current financial responsibility documents not submitted W V ❑R ❑COS <br /> 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current ( ❑R n COS <br /> 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan n R ❑COS <br /> 106 CCR 2632(d)(2) Failed to have an approved UST response plan o V C R ❑COS <br /> 107 CCR 2632(d)(1)(C) Plot planlsite map not submitted or failed to completely show where monitoring is performed ❑R ❑COS <br /> 108 CCR 2637(f),2638(e) Failed to notify the EHD 48 hours prior to conducting testing m V u R n COS <br /> 109 CCR 2637 Failed to test secondary containment ❑V n R u COS <br /> 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days ❑V n R n COS <br /> 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually ❑V n R n COS <br /> 112 HSC 25284.2 Failed to test spill containers annually n V C R n COS <br /> 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days ❑V ❑R n 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 ❑R ❑COS <br /> 115 CCR 2715(x) Failed to inform the EHD of designated operator identification or change within 30 days ❑V ❑R C COS <br /> 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification u V C 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 n R n COS <br /> 118 CCR 2883 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑V n R C COS <br /> 119 HSC 25299 Documents were falsified or misrepresented ❑V C R n COS <br /> 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification o V ❑R n COS <br /> 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ❑V ❑R ❑COS <br /> 122 CCR 2631 Q Failure to submit UST system component statement of compatibility for substance stored ❑V ❑R o COS <br /> ,. 9ite e <br /> 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions ❑V ❑R C COS <br /> 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 112 years C V C R u COS <br /> 203 CCR 2712(b) Failed to maintain records of monitoring,repair,lining,and upgrades on site n V n R o COS <br /> Page 1 of 3 <br />