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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.s4-qov.org/ehd Under 1 -6? 0 udd t a &h I Ct rt e 7. Facility Name: Facility Phone: Date: KAISER PERMANENTE (209)476-5817 June 28, 2017 Facility Address: CERS ID: 7373 WEST LN, STOCKTON, CA 95210 10180977 Inspection Contact: Title: Phone: Darryl Gardner Chief Engineer (209)969-3119 Inspection Type: Program: INSPECTION/REINSPECTION(No Charge) 2361 -UST FACILITY Consent For: Consent Given By: 0 Inspection 0 Photos 0 Samples Darryl Gardner, Chief Engineer Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: Dave Walker 12/28/2017 Kaylynn Rammell 06/15/2018 Service Technician Manufacturer's Training: Veeder Root, 11/17/17 CCR=California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations V=Violation R=Repeat violation COS=Corrected on site during inspection E 'M u vi- R 101 HSC 25284 No permit to operate ii V u R Ei COS 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system o V o R c 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 Ei V Ej R Ei COS 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan o V o R c COS 106 CCR 2632(d)(2) Failed to have an approved UST response plan o V o R c COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed o V Ei R Ei COS 108 CCR 2637(f),2638(e) Failed to notify the EHD 48 hours prior to conducting testing ❑V o R o COS 109 CCR 2637 Failed to test secondary containment ❑V o R o COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days m V Ei R m COS ill CCR 2638(a) Failed to test monitoring and leak detection equipment annually ci 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 o 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 Ei V o R ii COS 115 CCR 2715(a) Failed to inform the EHD of designated operator identification or change within 30 days o V c R D COS 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification o V ci R c 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 c COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests Ei V Ei R Ei COS 119 HSC 25299 Documents were falsified or misrepresented c V c R c COS 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification o V o R c COS 121 CCR 2712(o Failed to submit a written response within 30 days of receiving an inspection report o V o R c COS 122 CCR 26310) Failure to submit UST system component statement of compatibility for substance stored c V o R c COS Jr-, On S Records 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions c V c R c COS 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 1/2 years o V c R c COS 203 CCR 2712(b) Failed to maintain records of monitoring,repair,lining,and upgrades on site c V c R o COS FA0002602 PR0232494 SCO03 06/28/2017 EHD 23-01 Rev.09/22/16 Pagel of4 Underground Storage Tank Program OIR 9171 9690 4935 01314338 80