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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.sacehd.com UN6ERGl0UNDSTOikGEi4NK UST PROGRAM INSPECTION RLPOR., �.; Faid Facility Name. i l J R .:OS Facilit Phone 4` �� f3 Ins ection Date: 5 Facility Address `l U �i LU�n�r L (, u3LV OC �n �e)^ll `c� l CERS / ID: Inspection Contact: UL) ❑ ❑ ❑ Title: Phone: Inspection ❑ ❑ ❑ Program: Type - ova UST operating permit application for facility and tank information not submitted or current (V651) ❑ ❑ Consent Given For: ❑ Inspection ❑ Photos ❑ Sampling Consent Given By: ,� l v\ L/ U L ❑ ❑ Service Tech l ' , r Onsite: 0 in V it i/J 1 t� �,nt Exp. Date: 3 Designated Exp. Operator: �1 (� r v� U!- Date: Service Technician V I 1�C 4 � I' /% d'U l �' 1 ,*, l� V M�I 100-A / ! l / Manufacturers Training: (JIS��uu d / l l CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations Failed to notify the EHD 48 hours prior to conducting testing (V671) V = Violation R = Repeat COS = Corrected on site during inspection ' �.; Faid File Rerfew t .. R .:OS 101 HSC 25284 No permit to operate (V650) X. ❑ ❑ 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) ❑ ❑ 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan (V852) ❑ ❑ 106 CCR 2632(d)(2) Failed to have an approved UST response plan (V853) ❑ ❑ ❑ 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed (V655) ❑ ❑ ❑ 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 designated operator identification or change within 30 days (V658) ❑ ❑ ❑ 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification (V848) ❑ ❑ ❑ 117 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after (V666) ❑ Cl ❑ 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests (V667) ❑ ❑ ❑ 119 HSC 25299 Documents were falsified or misrepresented (V657) ❑ ❑ ❑ 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification (V840) ❑ ❑ ❑ 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report (V804) ❑ ❑ El CCR 26310) Failure to submit UST system component statement of compatibility for substance stored (V721) ❑ ❑ ❑ EHD 23-01 REV 07/28/16 ( / Page 1 UST INSPECTION REPORT �.; Faid V uCOS� 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 2712(b) Failed to maintain records of monitoring, repair, lining, and upgrades on site (V732) ❑ ❑ ❑ 204 CCR 2712(i) Current monitoring plan approved by the EHD not found on site (V734) Cl ❑ ❑ 205 CCR 2712(i) Failure to have an approved UST response plan available onsite (V654) ❑ ❑ ❑ 206 CCR 2712 Failure to comply with UST operating permit conditions (V738) ❑ ❑ 207 HSC 25294 Failed to record unauthorized lease from primary containment (V737) ❑ ❑ ❑ ReceivedIns By (initial): r: '- pe�� Inspector Phone: EHD 23-01 REV 07/28/16 ( / Page 1 UST INSPECTION REPORT