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0 • SAN .JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.socehd.com Received Inspr. I Inspector �� 3 By (initial): ?\/� : - k 4A Phone: L q _ t 7i EHD 23-01 REV 10/07/14 age 1 UST INSPECTION REPORT UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT Facility. Name: + '`' [�— yL No permit to operate (V650) Facility r, 3 Phone: • I 4 Inspection / Date: F- Facility No written agreement between tank owner and tank operator to monitor the tank system (V735) ❑ ❑ ❑ _ EPA CERS Address: yU . w UST Operating Permit Application for Facility and Tank information not submitted or current (V651) ID: ID: Facility1 Current BOE number not submitted (V652) Contact 106 Contact during inspection, if Contact: y ! C Phone: p C4,4 2, different from facility contact: Inspectio Type: l7 nL�. , CCR 2637(f), 2638(e) Failed to notify the EHD 48 hours prior to conducting testing (V671) Program: ''jj ? s bo CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations ❑ ❑ ❑ 110 CCR 2637(e) V = Violation R = Repeat COS = Corrected on site during inspection Received Inspr. I Inspector �� 3 By (initial): ?\/� : - k 4A Phone: L q _ t 7i EHD 23-01 REV 10/07/14 age 1 UST INSPECTION REPORT File Review V R COS 101 HSC 25284 No permit to operate (V650) ❑ ❑ ❑ 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 HSC 25286(c) Current BOE number not submitted (V652) ❑ ❑ ❑ 106 CCR 2632 Monitoring and response plans not current or approved by the EHD (V654) ❑ ❑ ❑ 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 a change of designated operator within 30 days (V658) ❑ ❑ ❑ 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification (V717) ❑ ❑ ❑ 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1000' of a public well (V672) ❑ ❑ ❑ 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test (V749) ❑ ❑ ❑ 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days (V669) ❑ ❑ ❑ 120 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after (V666) ❑ ❑ 1 ❑ 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests (V667) ❑ ❑ ❑ 122 HSC 25299 Documents were falsified or misrepresented (V657) ❑ ❑ ❑ 123 CCR 2661 Permit to repair UST system not obtained (V673) ❑ ❑ ❑ 124 CCR 2635(d) Failed to submit UST Certification of Installation/Modification (V840) ❑ ❑ ❑ 125 CCR 2712(1) Failed to submit a written response within 30 days of receiving an inspection report (V804) ❑ ❑ ❑ 126 1 HSC 25404(e)(4) Failed to report program data electronically (V817) ❑ ❑ ❑ Received Inspr. I Inspector �� 3 By (initial): ?\/� : - k 4A Phone: L q _ t 7i EHD 23-01 REV 10/07/14 age 1 UST INSPECTION REPORT On Site Records V R COS 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions (V725) x + 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(1) Current monitoring plan approved by the EHD not found on site (V734) ❑ ❑ ❑ 205 CCR 2712(i) Operating permit not on site (V738) ❑ ❑ ❑ 206 HSC 25294, 25295 Failed to record or report unauthorized release in appropriate time frame (V737) ❑ ❑ ❑ 207 CCR 2715 Designated operator did not inspect all required items and/or the inspection reports not completed (V723) ❑ ❑ ❑ Received Inspr. I Inspector �� 3 By (initial): ?\/� : - k 4A Phone: L q _ t 7i EHD 23-01 REV 10/07/14 age 1 UST INSPECTION REPORT