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• SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sigov.org/ehd <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM INSPECTION REPORT <br /> Faculty Kwik Serve Facility 950 W 11th Street, Tracy pato" Aug 21, 2012 <br /> Name: Address: <br /> Facility Mahesh Patel Title: Owner Phone: 832-1810 <br /> Contact: <br /> Inspection X Routine X Monitoring System Certification I I Installation CI Complaint-ID#: II Other: <br /> Type: <br /> (Authority HSC 25289) Mahesh Patel Owner <br /> Consent for. X Inspection I I Sampling X Photos Granted by: Title: <br /> Monitoring Piping Veeder-Root TLS-350 System: XPressurized []Suction []Gravity Preen XMechanical ❑Audible/visual <br /> ll <br /> Panel: System: Prevention: <br /> UST 5 6 7 <br /> - Product- - - DSL----- --87-octane-- --91-octane - -------- -- ------------- ------------- ------------- -----------F <br /> -- -------- <br /> Designated Date: <br /> David Winkler ICC Exp. <br /> Operator. 3-2-14 violations: XM1-Release Detection [I M2-Release Prevention 111013-Both <br /> [CC <br /> Te site Service David Winkler Dat : 3-5-14 Manufacturers VR: 2-13-14, TT: 3-31-14 <br /> Technician: Date: Training: <br /> VIOLATIONS <br /> # I C1 C2 M Code Section HSC=California Health and Safety Code;CCR=California Code of Regulations <br /> C1=Class 1 violation;C2=Class 2 violation;M=Minor violation <br /> Fite Review <br /> 101 HSC 25284 No permit to operate <br /> 102 HSC 25404.5 Annual operating fees not paid <br /> 103 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 HSC 25292.2 Current financial responsibility documents not on file with the Environmental Health Department(EHD) <br /> 105 CCR 2711 Current unified Program Consolidated Forms not on file with the EHD(Facility and tank form) <br /> lJti l 1 1UGH 2b3Z!b) IMonitoring F og,am.(Monitonrxesacnse Finns)is not current or approved Dythe c#v I <br /> ! <br /> ---- -- n...... <br /> .. _r,l-,.. r')O:;.,". <br /> t---------- <br /> C <br /> ------ ; -:,2 r ,5,.ti. 9;C TrVL.,,T..: n, ..n._.noS_f'._..-, -.,cri.. .- -^..._ .v..: <br /> 43 <br /> I'..¢:a.. -Sic,il i.u,001aiflev <br /> - .. ...,- <br /> : r <br /> s C f:sc U'Y !cv�'t US!t,-_-u --'- s aei;c Ji c-,,t t.li-- x <br /> *,rs�. *a3✓d-aJc., s -L,;sa,� i y <br /> rt <br /> s„ ,tie< <� ,, y„,is ;�i rr zl€% i;,�venr iv,-_?dinc and reC 4 ,til aiia Ins i <br /> i yup `1K 2 7 12 i) i ivion1141 Irig plan,eesiton5e pian,anruf{ar Operailny peqnsit a r i ail ccrlGiiiuns I10 tr.aviee j <br /> uria,.�ur ze rS1�-SL...mac ^)_mid:..�t a u 58CGritt::ry containment,... d"a C. wit-on eiC�}. i ho;;- 'roll <br /> (c p <br /> tti„Gun <br /> Insoector I Received Title: <br /> Garrett Backus (209) 468-2986 1 � i p�� <br /> t=Hr)7t-n2 Rev 04/19/12 Page 1 UST INSPECTION REPORT <br />