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SAN 10 A Q U I N Environmental Health Department _. . _ COUNTY Underground Storage Tank Program Inspection Report Facility Name : Facility Phone: Date: PACIFIC BELL - UE058 (TRACY) (209) 603-9726 February 11 , 2019 Facility Address : CERS ID: 10 E TWELFTH St, TRACY, CA 95376 10181547 Inspection Contact: Title: Phone: Thuy Tran Environmental site manage (209) 474-4022 Inspection Type: Program: ROUTINE INSPECTION - Operating Permit 2361 - UST FACILITY Consent For: Consent Given By: 0 Inspection N Photos 0 Samples Thuy Tran , Environmental site manager Service Technician Onsite : Exp. Date: Designated Operator: Exp. Date: Gage Heart 06/12/2019 George Koffel 10/23/2019 Service Technician Manufacturer's Training : Veeder Root, 07/06/ 19 , SB , 07/12/19 CCR = Title 23 California Cade of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations V = Violation R = Repeat violation COS = Corrected on site during inspection File Review 101 HSC 25284 Failed to obtain a permit to operate from the EHD including but not limited to unpaid permit fees ❑ V ❑ R ❑ COS 102 HSC 25284(a) (3) (A)/(B) No written agreement between tank owner and tank operator to monitor the tank system ❑ V ❑ R ❑ COS 103 HSC 25292.21 25299. 30 Failure to submit and maintain complete and current financial responsibility documents ❑ V ❑ R ❑ COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current ❑ V ❑ R ❑ COS 105 CCR 2632(d)(1 ) , Failed to have an approved UST monitoring plan ❑ V ❑ R ❑ COS 2634(d) 106 CCR 2632(d) (2) , Failed to have an approved UST response plan ❑ V ❑ R ❑ COS 2634(e) 107 CCR 2632(d) (1 )(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed ❑ V ❑ R ❑ COS 108 CCR 2637, 2638 (e) , Failed to notify the EHD 48 hours prior to conducting testing ❑ V ❑ R ❑ COS 2643 (g) 109 CCR 2637(a-d) , 2712 Failed to test secondary containment, or failed to maintain test records for 36 months ❑ V ❑ R ❑ COS 110 CCR 2637(e) , 2637(f) Failed to submit "Secondary Containment Testing Report Form" within 30 days after the test ❑ V ❑ R ❑ COS 111 CCR 2638 (a) & (b) , Failed to test monitoring and leak detection equipment annually ❑ V ❑ R ❑ COS 26410) 112 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance ❑ V ❑ R ❑ COS 113 CCR 2638(c) , 2638(d) Failure to submit "Monitoring System Certification Form" within 30 days of completion of the test ❑ V ❑ R ❑ COS 114 CCR 2636(f) (3) , 2643(c) No 0. 1 gph annual line integrity test for pressurized piping , or within 30 days after repair ❑ V ❑ R ❑ COS (3) 115 CCR 2715 (a) (1 ) (B) , " Designated Underground Storage Tank Operator Identification Farm" not submitted within 30 days ❑ V ❑ R ❑ COS 2715(a) (3) 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification ❑ V ❑ R ❑ COS 117 CCR 2663, 2712(b) (6) Failure to comply with tank lining , recordkeeping , and inspection requirements ❑ V ❑ R ❑ COS 118 CCR 2715 (a) (1 ) (A) , Failure to submit the " Underground Storage Tank Statement of Understgn8ing and Compliance Form" ❑ V ❑ R ❑ COS 2715(a)(2) 119 HSC 25299(a)(8)3 Documents were falsified or misrepresented f 3IN V3 ❑ V ❑ R ❑ COS 25299(b)(7) 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification io ❑ R ❑ COS 121 CCR 2712 (f) Failed to submit a written response within 30 days of receiving an inspection report It e. ❑ V ❑ R ❑ COS ii � 122 CCR 2631 , 2640. 11 Failure to submit and/or maintain documentation regarding compatibility for US�*'y ' tem components ❑ V ❑ R ❑ COS 2665r2711 FA0003956 PR0231873 SCO01 02/11 /2019 EHD 23-01 Rev. 09/28/2018 Pagel of S Underground Storage Tank Program OIR 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www. sjcehd . com