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Page 1 of 4 <br />San Joaquin County k --- <br />Environmental Health Department AUG 0 9 2016 <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/�4Q�hd <br />Underground Storage Tank Program Inspection Report <br />Facility Name: <br />Facility Phone: <br />Date: <br />Facility Address: <br />CERS ID: <br />Inspection Contact: <br />Title: Phone: <br />Inspection Type:Program: <br />Consent For: <br />Inspection 77 Photos <br />Sam ples <br />Consent G By. <br />i <br />Service Technician Onsite: <br />Exp. Date: <br />Designated Operator: <br />Exp. Date: <br />Service Technician Manufacturer's Training <br />CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations <br />V = Violation R = Repeat violation COS = Corrected on site during inspectio <br />File Review <br />1.0.1 <br />HSC 25284 <br />No permit to operate <br />oV <br />cR <br />oCOS <br />102 <br />HSC 25284(a)(3) <br />No written agreement between tank owner and tank operator to monitor the tank system <br />o V <br />o R <br />oCOS <br />103 <br />HSC 25292.2 <br />Current financial responsibility documents not submitted <br />o V <br />o R <br />cCOS <br />104 <br />CCR 2711 <br />UST operating permit application for facility and tank information not submitted or current <br />o V <br />o R <br />oCOS <br />105 <br />CCR 2632(d)(1) <br />Failed to have an approved UST monitoring plan <br />o V <br />o R <br />cCOS <br />106 <br />j CCR 2632(d)(2) <br />Failed to have an approved UST response plan <br />ii V <br />o R <br />oCOS <br />107 <br />CCR 2632(d)(1)(C) <br />Plot plan/site map not submitted or failed to completely show where monitoring is performed <br />r-1 V <br />n R <br />oCOS <br />108 <br />CCR 2637(f), 2638(e) <br />Failed to notify the EHD 48 hours prior to conducting testing <br />o V <br />o R <br />oCOS <br />109 <br />CCR 2637 <br />Failed to test secondary containment <br />o V <br />o R <br />oCOS <br />110 <br />CCR 2637(e) <br />Failed to submit secondary containment test report within 30 days <br />o V <br />c R <br />o COS <br />Ill <br />CCR 2638(a) <br />Failed to test monitoring and leak detection equipment annually <br />o V <br />o R <br />Ei COS <br />112 <br />HSC 25284.2 <br />Failed to test spill containers annually <br />o V <br />o R <br />o COS <br />113 <br />CCR 2638(d) <br />Failed to submit monitoring system certification test report within 30 days <br />Ei V <br />Ei R <br />ci COS <br />114 <br />CCR 2636(f) <br />Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down <br />o V <br />o R <br />o COS <br />115 <br />CCR 2715(a) <br />Failed to inform the EHD of designated operator identification or change within 30 days <br />o V <br />o R <br />oCOS <br />116 <br />CCR 2715 <br />Designated operator, service tech or installer did not possess current ICC certification <br />o V <br />o R <br />cCOS <br />117 <br />CCR 2663 <br />Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after <br />o V <br />n R <br />o COS <br />118 <br />CCR 2663 <br />Failed to submit tank lining certification within 30 days or to conduct proper tests <br />o V <br />o R <br />oCOS <br />119 <br />HSC 25299 <br />Documents were falsified or misrepresented <br />o V <br />c R <br />o COS <br />120 <br />CCR 2635(d) <br />Failed to submit UST Certification of Installation/Modification <br />o V <br />o R <br />o COS <br />121 <br />CCR 2712(f) <br />Failed to submit a written response within 30 days of receiving an inspection report <br />o V <br />o R <br />oCOS <br />122 <br />CCR 26310) <br />Failure to submit UST system component statement of compatibility for substance stored <br />o V <br />o R <br />cCOS <br />On Site Records <br />201 <br />CCR 2712(b) <br />Failed to maintain alarm logs and/or records of follow up actions <br />oV <br />o R <br />c COS <br />202 <br />CCR 2712(b) <br />Failed to maintain cathodic protection test records on site for at least 6 1/2 years <br />o V <br />c R <br />o COS <br />203 <br />CCR 2712(b) <br />Failed to maintain records of monitoring, repair, lining, and upgrades on site <br />o V <br />o R <br />cCOS <br />Page 1 of 4 <br />