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Nftwl SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209)468-3420 Fax: (209)468-3433 Web:www.sicehd.com UNDERGROUNDSTORAGETANK UST PROGRAM INSPECTION REPORT Facility Facility Inspection 1 Name: S' -0 ' Phone. " - Date: FacilityEPA CER)01 Address: V ID: ID: Facility1 Contact during inspection,if Contact RfllD Phone: t{^/ different from facility contact: Inspection Program: Type: Rall U S'r CCR=California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations V=Violation R=Repeat COS=Corrected on site during inspection File Review V R COS 101 HSC 25284 No permit to operate(V650) ❑ 0 0 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system(V735) ❑ 0 0 103 HSC 25292.2 Current financial responsibility documents not submitted(V720) 0 ❑ ❑ 104 CCR 2711 UST Operating Permit Application for Facility and Tank information not submitted or current(V651) ❑ ❑ ❑ 105 HSC 25286(c) Current BOE number not submitted(V652) ❑ ❑ ❑ 106 CCR 2632 Monitoring and response plans not current or approved by the EHD(V654) ❑ ❑ 0 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed(V655) ❑ ❑ ❑ 108 CCR 2637(% Failed to notify the EHD 48 hours prior to conducting testing(V671) ❑ 0 0 2638 e 109 CCR 2637 Failed to test secondary containment(V660) 0 ❑ 0 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days(V662) 0 ❑ 0 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually(V659) ❑ ❑ ❑ 112 HSC 25284.2 Failed to test spill containers annually(V661) 0 0 0 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days(V823) 0 ❑ ❑ 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down(V663) ❑ ❑ ❑ 115 CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days(V658) ❑ 0 0 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification(V717) ❑ ❑ 0 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1000'of a public well(V672) ❑ ❑ o 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test(V749) ❑ 0 0 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days(V669) 0 0 0 120 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after(V666) ❑ ❑ ❑ 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests(V667) ❑ ❑ ❑ 122 HSC 25299 Documents were falsified or misrepresented(V657) 0 0 o 123 CCR 2661 Permit to repair UST system not obtained(V673) ❑ ❑ 0 124 CCR 2635(d) Failed to submit UST Certification of InstallationlModification(V840) ❑ ❑ ❑ 125 CCR 2712(1) Failed to submit a wriften response within 30 days of receiving an inspection report(V804) 0 0 0 126 HSC 25404(e)(4) Failed to report program data electronically(V817) 0 0 On Site Records V 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions(V725) 0 0 0 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 1/2 years(V733) 0 ❑ 0 203 CCR 2712(b) Failed to maintain records of monitoring,repair,lining,and upgrades on site(V732) 0 0 ❑ 204 CCR 2712(i) Current monitoring plan approved by the EHD not found on site(V734) ❑ ❑ ❑ 205 CCR 2712(1) Operating permit not on site(V738) 0 0 ❑ 206 HSC 25294"25295 Failed to record or report unauthorized release in appropriate time frame(V737) ❑ ❑ 0 207 CCR 2715 Designated operator did not inspect all required items and/or the inspection reports not completed(V723) 0 Received In or: Inspector y�/' By(initial): Phone: ZO 8-3 yD EHD 23-01 REV 10/07/14 Page 1 UST INSPECTION REPORT