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,qw San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, California95205-6232 Telephone. (209) 468-3420 Fax: (209) 468-3433 Web. www.sigov.org/ehd Underground Storage Tank Program Inspection Report I Facility Name: HSC 25284 No permit to operate Facility Phone: o V Date: u COS 102 HSC 25284(a)(3) Z� 7 2" Facility Address: D COS 103 HSC 25292.2 CERS ID: Ei V o R Ei COS Inspection Contact: CCR 2711 Title: Phone: o R E COS 105 j HSC 25286(c) Current BOE number not submitted Inspection Type: o V --F—Program: o COS 106 FP 4- L C)UTiNIE S! P" A(I'171 "TY- F', M- "JEc! iL 12- j–! o R Consent For: Consent Given By: CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed Inspection Photos 0 Samples o V o R o COS Service Technician Onsite: Exp. Date: –[—Designated Operator: Exp. Date: c R o COS 109 CCR 2637 0 4 4 7 Service Technician Manufacturer's Training Z3= V = Violation R = Repeat violation COS = Corrected on site during inspection 101 HSC 25284 No permit to operate o V Ei R u COS 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system o V o R D COS 103 HSC 25292.2 Current financial responsibility documents not submitted Ei V o R Ei COS 104 CCR 2711 UST Operating Permit Application for Facility and Tank information not submitted or current Ej V o R E COS 105 j HSC 25286(c) Current BOE number not submitted o V o R o COS 106 CCR 2632 Monitoring and response plans not current or approved by the EHD Ej V o R o 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(o, 2638(e) Failed to notify the EHD 48 hours prior to conducting testing u V c R o COS 109 CCR 2637 Failed to test secondary containment o V o R o COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days o V c R o COS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually Ei V u R Ei COS 112 HSC 25284.2 Failed to test spill containers annually o V u R o COS 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days o V D R o COS 114 CCR 2636(o Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down o V o R Ej COS 115 CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days Ei V o R Ei COS 116 j CCR 2715 Designated operator, service tech or installer did not possess current ]CC certification Ei V o R Ei COS 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1000' of a public well o V o R o COS 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test c V o R o COS 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days ii V Ei R o COS 120 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after o V Ei R o COS 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests o V o R c COS 122 HSC 25299 Documents were falsified or misrepresented Ej V Ei R o COS 123 CCR 2661 Permit to repair UST system not obtained o V Ei R o COS 124 CCR 2635(d) Failed to submit UST Certification of Installation/Modification o V o R o COS 125 CCR 27120 Failed to submit a written response within 30 days of receiving an inspection report o V o R o COS Received by (initial):' inspector: F P,,1F I N A11-1 Z A R E r�z F R F Q Phone: " 11 '2 0`9,� 95 3 -7" Date: 0 1 /29/2016 Page 1 of 4