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0 SAN i ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, California 95202-3029 Telephone: (209)468-3420 :(209)468-3433 e .siaov.o[g/ehd/unitiii.htmi INSPECTIONUNDERGROUND STORAGE TANK (UST) PROGRAM Facility name: Designated Operator: Exp.date: Inspection Dat s U T ` mo i® 7 /iD Facility address: UST# —T ° / Product Facility contact: / Title: Phone: Mon'oring panel: Pi i s tem: Ovell prevention: Pressurized ❑Suction ❑Gravity Mechanical ❑Audible/visual Inspection Violations: outine onitoring Certification ❑Installation ❑Other: 1-RDetect ❑M2-RPrev ❑M-3 Both n site Technici 's e: ICC Service Te nicia Exp. ate: anufacturer's Training: �I IU Code Section VIOLATION(S) HSC=California Health&Safety Code;CCR=California Code of Regulations V V=Violation;RV=Re eat Violation V 1 HSC 25284 No permit to operate 2 CCR 2637 Secondary containment:(a)test not performed;(e)test report not submitted within 30 days;(f)test notification not provided to the EHD at least 48 hours prior to conducting the test 3 CCR 2711(b)&(c) Current Unified Program Consolidated Forms not on file with the EHD(Facility and tank form) 4 HSC 25292.2 Current financial responsibility documents not on file with the EHD 5 CCR 2632(b) Monitoring Program(Monitoring Response Plan)is not current or approved by the local agency 6 CCR 2712(1) Monitoring and/or response plan is not onsite Maintenance&monitoring records not maintained 3 years,cathodic protection records for 6%years, (M1) written performance claims pertaining to release detection systems for 5 years,or records of repairs,linings,and 7 CCR 2712(b) upgrades for the life of the tank. Monitoring records include:(1)date and time of all monitoring or sampling;(2) monitoring equipment calibration and maintenance records;(3)results of any visual observations;(4)results of sample analysis performed a lab or in the field;(5)logs of all readings of gauges or other monitoring equipment, ground water elevations,or other test results;(6 results of inventoryreadings and reconciliations. 8 CCR 2643(4) Daily monitoring of suction piping(pre-January 1, 1984)not performed 9 HSC 25292.1 UST system is not operated to prevent unauthorized release,including spills and overfills 10 CCR 2632(c)(2) Monitoring system is not present in the interstitial space of a double walled UST/piping ( 1j 11 CCR 2630(d) UST monitoring equipment is not installed or maintained to detect a leak at the earliest opportunity (M1) 12 HSC 25291(b) UST system monitoring equipment is not operational ( 1) 13 CCR 2636(f)(1) Failed to maintain a continuous monitoring system for underground piping&UDC that to activates an ( 1) audible and visual alarm or sto s flow of roduct at the dis enser when it detects a leak 14 CCR 2631(a) Primary containment is not product tight 15 HSC 25291(a)(2) Secondary containment for UST system is not tight 16 CCR 2636(c)(1) All releases in secondary piping do not flow to a collection sump 17 HSC 25291(f) Line leak detector(s)not installed (M7) 18 CCR 2635(b)(1) Spill container not installed,failed to contain a minimum capacity of five gallons,or failed to provide (M2) a means to keep the spill container empty 19 CCR 2635(b)(2) Overfill prevention system was overridden or failed to meet overfill requirements in this section (W) 20 CCR 2636(a) Failed to have secondary containment or continuous monitoring(includes conventional suction piping) 21 HSC 25291(e) Water in 21 containment not removed,analyzed&properly disposed of Unauthorized release that:(c)did not escape secondary containment and cleaned up within eight hours (M1) 22 CCR 2650 was not recorded;(e)escaped secondary containment,not cleaned ul after eight hours,or a sudden loss of product was not reported to the EHD within 24 hours 23a CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days 23b CCR 2715(b) Designated operator did not possess a current ICC UST System Operator certification Designated operator monthly inspection:(c)(1)alarms not documented;(c)(2-4)spill containers,UDCs,and 23c CCR 2715(c),(d),(e) sumps(if necessary)not inspected;(c)(5)required test dates not checked or noted;(c)(6)employee training not verified;(d)(e)monthl ins action reports not maintained on site for at least 12 months 23d CCR 2715(f) Designated operator employee training: performed;(2)not current for at least one employee on site;(3) to not ke t EHD INSP CTOR: CEIV l': TITLE: EHD 23-02-002 REV 12/09- Page 1 UST INSPECTION REPORT