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,p% SAN ..JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www,sdcehd.com UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT Facility V R COS Facility HSC 25284 Inspection Name: -Tt- ❑ ❑ 102 Phone: No written agreement between tank owner and tank operator to monitor the tank system (V735) Date: FacilityCERS CA KA 103 HSC 25292.2 Current financial responsibility documents not submitted (V720) ❑ Address: I LA J 104 CCR 2711 UST Operating Permit Application for Facility and Tank information not submitted or current (V651) ID: Inspection Contact: 2 e 105 Title:\\ - 1 T C L1 ❑ Phone: CA -z - 4- ( _ c - Inspection CCR 2632 Monitoring and response plans not current or approved by the EHD (V654) Program: X ❑ Type: `.�, CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed (V655) K, ❑ ❑ Consent Given For: �fhotos Consent Failed to notify the EHD 48 hours prior to conducting testing (V671) ❑ dfnspection Veb'�ampling I Given By: 1 (\ Failed to test secondary containment (V660) Service Tech� ,� Onsite: i--�r l S Exp. Date: 110 Designated 1� Operator. C r1S Exp. 1 Date: (� Service Technician ❑ ❑ 111 CCR 2638(a) Manufacturers Training: %QC�11\1 ❑ ❑ ❑ 112 CCR = California Code of Regulations HSC = Heafth and Safety Code I CFW- Code of Federal Regulations ❑ ❑ ❑ 113 V = Violation R = Repeat COS = Corrected on site during inspection EHD 23-01//REV 08/07/15 U Page 1 1- UST INSPECTION REPORT On Site Records Wkwililly File Review V R COS 101 HSC 25284 No permit to operate (V650) ❑ ❑ ❑ 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system (V735) ❑ ❑ ❑ 103 HSC 25292.2 Current financial responsibility documents not submitted (V720) ❑ ❑ ❑ 104 CCR 2711 UST Operating Permit Application for Facility and Tank information not submitted or current (V651) ')Q ❑ ❑ 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) X X ❑ 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed (V655) K, ❑ ❑ 108 CCR 2637(f), 2638(e) Failed to notify the EHD 48 hours prior to conducting testing (V671) ❑ ❑ ❑ 109 CCR 2637 Failed to test secondary containment (V660) ❑ ❑ ❑ 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days (V662) ❑ ❑ ❑ 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) ❑ ❑ ❑ 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days (V823) ❑ ❑ ❑ 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) ❑ ❑ ❑ 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification (V717) ❑ ❑ ❑ 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1000' of a public well (V672) ❑ ❑ ❑ 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test (V749) ❑ ❑ ❑ 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days (V669) ❑ ❑ ❑ 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) ❑ ❑ ❑ 123 CCR 2661 Permit to repair UST system not obtained (V673) ❑ ❑ ❑ 124 CCR 2635(d) Failed to submit UST Certification of Installation/Modification (V840) ❑ ❑ ❑ 125 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report (V804) ❑ ❑ ❑ 126 HSC 25404(e)(4) Failed to report program data electronically (V817) ❑ ❑ ❑ EHD 23-01//REV 08/07/15 U Page 1 1- UST INSPECTION REPORT On Site Records V R COS 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions (V725) ❑ ❑ ❑ 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 1/2 years (V733) ❑ ❑ ❑ 203 CCR 27 (b) Failed to maintain re f monitoring, repair, lining, and upgrades on site (V732) ❑ ❑ ❑ Received By (initial): Inspecto - Inspect Phone �j-�C) EHD 23-01//REV 08/07/15 U Page 1 1- UST INSPECTION REPORT