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0 <br /> San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, Califomia95205-6232 <br /> Telephone: (209)468-3420 Fax:(209)468-3433 Web.,w".si-ciov.org/eha <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Phone: Date: <br /> M' ''Jfflll 'i , ?015 <br /> Facility Address: CERS ID: <br /> Inspection Contact: Phone: <br /> Inspection Type. Program: <br /> I J FFY <br /> Consent For: Consent Given By: <br /> 1D. InsDection 1, Photos i Samples <br /> Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: <br /> Service Technician Manufacturer's Training <br /> CCR=California Code of Regula-tons HSC=Health and Safety Code---C-FR-=Code of federal We-g—ulatlons <br /> V=Violation R=Repeat violation COS=Corrected on site during Inspection <br /> File Review <br /> 101 HSC 25284 No permit to operate LiV u oCOS <br /> — <br /> 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system oV DR oCOS <br /> 103 HSC 25292.2 Current financial responsibility documents not submitted oV uR uCOS <br /> 104 CCR 27111 UST Operating Permit Application for Facility and Tank information not submitted or current a V Ei R o COS <br /> 105 HSC 26286(c) Current BOE number not submitted DV DR o COS <br /> 106 CCR 2632 Monitoring and response plans not current or approved by the EHD [IV DR u COS <br /> 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 0 COS <br /> 108 CCR 2637(0,2638(e) Failed to notify the EHD 48 hours prior to conducting testing o V o R o COS <br /> 109 CCR 2637 Failed to test secondary containment o V c R o COS <br /> 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days D V o R Li COS <br /> ill CCR 2638(a) Failed to test monitoring and leak detection equipment annually o V o R o COS <br /> 112 HSC 25284.2 Failed to test spill containers annually LiV DR o COS— I r <br /> 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days L,V o R Li COS <br /> 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 oCOS <br /> F115 CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days wV ■R -COS <br /> [116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification oV oR oCOS <br /> 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1000'of a public well toV a R o COS <br /> 118 1 HSC 25292.5 Failed to repair and retest system due to failed ELD test ❑V o R n COS <br /> 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days D V a R o COS <br /> 120 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after u DR c COS <br /> 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests oV DR o COS <br /> 122 HSC 25299 Documents were falsified or misrepresented oV DR o COS <br /> 123 CCR 2661 Permit to repair UST system not obtained oV DR o COS <br /> 124 CCR 2635(d) Failed to submit UST Certification of Installation/Modification DV DR ocos <br /> 125 CCR 2712(t) Failed to submit a written response within 30 days of receiving an inspection report --v R u COS <br /> Received by Inspector: Phone: ---FDate: <br /> riws—pe—ctl I o t', <br /> (initial): f;('Idnf W--1 1' (209) 953 769�) <br /> �a <br /> el f5 <br />