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San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.s44ov.orq/ehd Facility Name: Facility Phone: Date: te A venve- A rL 8 CU/05/a0r] act t ress! GER(u �� i i i l.7- 1'oSeM',te Ave- 5 nspec on ac : i e: one: nspec tontype: Program: S o i o 'a.362. Consent For: Consent ?1yen _y: �� VInspection Q`Photos CISamples (�I�rnc., Se Technician Onsite: Exp. ate: DesignatedOperator: Exp. ate: MIX r\ r (,n 5 1?140 Service ec ntctan anu ac urers raining: Tv,n>< Tes.;er' 5 /A 1 /5 %off 17 ✓eeA- C,; t "7 /& ld v CCR=California Codeo egu ations HSC=Health and Safety Code GFR=Code of a era Regulation V=Violation R=Repeat violation COS=Corrected on site during inspection File Review 101 HSC 25284 No permit to operate o V o R o COS 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system o V o R o COS 103 HSC 25292.2 Current financial responsibility documents not submitted o V o R o COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current o V o R o COS 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan a V o R o COS 106 CCR 2632(d)(2) Failed to have an approved UST response plan o V o R n COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed o V o R o COS 108 CCR 2637(f),2638(e) Failed to notify the EHD 48 hours prior to conducting testing n V o R o COS 109 CCR 2637 Failed to test secondary containment 19 V o R o COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days n V o R o COS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually o V o R o COS 112 HSC 25284.2 Failed to test spill containers annually o V o R o COS 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days o V c R o COS 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down c V o R o COS 115 CCR 2715(a) Failed to inform the EHD of designated operator identification or change within 30 days o V o R o COS 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification o V o R o COS 117 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after o V o R o COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests o V o R ❑COS 119 HSC 25299 Documents were falsified or misrepresented o V o R o COS 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification o V c R ❑COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report AV o R n COS 122 CCR 26310) Failure to submit UST system component statement of compatibility for substance stored o V o R n COS iy S ' - '' "'°"` t? l .ice '�. r" ..r - �` ��*fi c?"'' -:•::+�f" `'9''Si, 'T.. ` Cice "� 5w On bite Re ordj � � 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions V o R n COS 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 1/2 years o V o R o COS 203 CCR 2712(b) Failed to maintain records of monitoring,repair,lining,and upgrades on site o V o R ❑COS Page 1 of 3