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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, California 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sugov.org/ehd/unitiii.htmi <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />FacilityF <br />-yL <br />ci <br />� S <br />C2 <br />M <br />Code Section HSC = California Health and Safety Code; CCR = California Code of Regulations <br />Inspectio <br />Name: <br />' • <br />ss: , <br />i4 <br />� File RevieW <br />101 <br />Date: I — <br />Facility <br />HSC 25284 No permit to operate <br />102 <br />Title: <br />Phon - <br />Contact: <br />LA A - <br />HSC 25284(a)(3) No written agreement between the person that the operating permit was issued to and the tank operator to <br />monitor the tanks stem <br />104 <br />Inspection /Routine <br />Type: (Monitoring Syste <br />Certification <br />Installation - Complaint - ID#: <br />105 <br />Other: <br />(Authority HSC 25289) <br />Consent for: 'Inspection , p <br />Sampling hotos <br />Grantedby: �.{,/�/ - <br />` �v <br />V'V f �' <br />Title: t <br />Monitoring,( nn <br />Panel: V 1— TL <br />Piping <br />System: <br />Pressurized F. Suction -,Gravity <br />CCR 2632(b) Monitoring Program (Monitoring & Response Plans) is not current or approved by the EHD <br />O rfill <br />Prevention: <br />Mechanical F- Audible/visual <br />UST <br />CCR 2632(d)(1)(C) Plot plan/site map not submitted or fails to completely show where monitoring is performed <br />108 <br />CCR 2637 Secondary containment: (a) test not performed; (e) test report not submitted within 30 d�ys; (f) test notification <br />not provided to the EHD at least 48 hours prior to conductingthe test <br />109 <br />Monitoring equipment certification: (a) not performed annually; (d) test report nc# submitted within 30 days; <br />CCR 2638 (e) test notification not provided to the EHD at le st 48 hours prior to conducting an installation, repair, <br />replacement, calibration, or certification <br />--Product--- <br />------------- <br />-------------- <br />------------- <br />HSC 25291(f) Annual line leak detector test not performed (M1) <br />-------------- <br />------------- <br />--- <br />---i----- <br />-------------- <br />112 <br />------------ <br />-----------•- <br />Operator: A M n/IG7`,p�y) i^ <br />Operator: Lc � v ( ,l-ur ply'►' ' <br />ICC Exp. <br />Date: <br />113 <br />Violations: I M1 -Release Detection <br />M2 -Release Prevention -M3-Both <br />On Site Servi <br />Technician: v I <br />ICC Exp.- <br />V <br />Z�n Manufactureds <br />12i�' <br />11 • 1✓ <br />Date: <br />l') Training: <br />��+�1, <br />VIOLATIONS <br /># <br />C1 <br />C2 <br />M <br />Code Section HSC = California Health and Safety Code; CCR = California Code of Regulations <br />Cl = Class 1 violation; C2 = Class 2 violation; M = Minor violation <br />' • <br />;,. - <br />i4 <br />� File RevieW <br />101 <br />HSC 25284 No permit to operate <br />102 <br />HSC 25404.5 Annual operating fees not paid <br />103 <br />HSC 25284(a)(3) No written agreement between the person that the operating permit was issued to and the tank operator to <br />monitor the tanks stem <br />104 <br />HSC 25292.2 Current financial responsibility documents not on file with the Environmental Health Department (EHD) <br />105 <br />CCR 2711 Current Unified Program Consolidated Forms not on file with the EHD (Facility and tank form) <br />106 <br />CCR 2632(b) Monitoring Program (Monitoring & Response Plans) is not current or approved by the EHD <br />107 <br />CCR 2632(d)(1)(C) Plot plan/site map not submitted or fails to completely show where monitoring is performed <br />108 <br />CCR 2637 Secondary containment: (a) test not performed; (e) test report not submitted within 30 d�ys; (f) test notification <br />not provided to the EHD at least 48 hours prior to conductingthe test <br />109 <br />Monitoring equipment certification: (a) not performed annually; (d) test report nc# submitted within 30 days; <br />CCR 2638 (e) test notification not provided to the EHD at le st 48 hours prior to conducting an installation, repair, <br />replacement, calibration, or certification <br />110 <br />HSC 25291(f) Annual line leak detector test not performed (M1) <br />111 <br />HSC 25284.2 Annual spill containment testing not performed <br />112 <br />CCR 2636(f)(4) Annual line tightness test not performed if positive shutdown or fail safe not present (M1) <br />113 <br />CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days <br />114 <br />CCR 2715(b) Designated operator does not possess a current ICC CA UST System Operator certification <br />115 <br />CCR 2660(k) Repair for tank or piping not tested for tightness after completion of the repair pursuant to (M2) <br />permit conditions <br />116 <br />HSC 25292.5 Enhanced leak detection (ELD) testing not performed on a system located within 1000' of public well, or <br />failures not repaired and retested <br />117 <br />CCR 2661 Permit to repair UST system not obtained <br />118 <br />HSC 25286(a) Operational permit not amended when UST storage and/or monitoring system changed <br />119 <br />HSC 25298(b) Permit to temporarily close UST system not obtained <br />120 <br />HSC 25298(c) Permit to close UST system not obtained <br />1 <br />On Site Records <br />201 <br />Maintenance & monitoring records not maintained 3 years, cathodic protection records for 6'h years, written <br />performance claims pertaining to release detection systems for 5 years, or records of repairs, linings, and <br />CCR 2712(b) upgrades for the life of the tank. Monitoring records include: (1) date and time of all monitoring or sampling; <br />(2) monitoring equipment calibration and maintenance records; (3) results of any visual observations; (4) <br />results of sample analysis performed a lab or in the field; (5) logs of all readings of gauges or other monitoring <br />equipment, round water elevations, or other test results; 6 results of inventory readings and reconciliations <br />202 <br />CCR 2712(i) Monitoring plan, response plan, and/or operating permit and all conditions not onsite <br />203 <br />Unauthorized release that: (c) did not escape secondary containment and cleaned up within eight hours (M1) <br />CCR 2650 was not recorded; (e) escaped secondary containment, not cleaned up after eight hours, or a sudden loss of <br />product was not reported to the EHD within 24 hours <br />Received By: <br />Title: <br />)& <br />EHD 23-02 Rev 911/11 / Page 1 UST INSPECTION REPORT <br />