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S AF1J O hHQ U I N Environmental Health Department COUNTY Int Underground Storage Tank Program Inspection Report Facility Name: Facility Address : Date : File Review 121 HSC 25299 (a) (8) , False statements, representation , or certification made on an application , record , or other document ❑ V o R ❑ COS 25299 (b)(7) 122 CCR 2712(f) Failure to implement corrections and submit written response within 30 days of receiving the report V ❑ R ❑ COS On Site Records 201 HSC 25293 Failure to maintain UST records to enable the UPA to determine whether the UST is in compliance ❑ V o R ❑ COS 202 CCR 2712 (i) Failure to retain a paper or electronic copy of the permit to operate at the facility ❑ V ❑ R o COS 203 CCR 2712(b) (1 -2) Failure to maintain monitoring records for 36 months and maintenance records for 60 months ❑ V ❑ R o COS 204 CCR 2712(b) (6) Failure to maintain records of repairs, lining , and upgrades on site, for the life of the UST ❑ V ❑ R o COS 205 CCR 2712(i) Failure to submit and have current UST Monitoring Plan readily accessible at the facility o V ❑ R o COS 206 CCR 2712(i) , 2634(e) Failure to submit and have a current UST Response Plan readily available on site ❑ V ❑ R ❑ COS 207 CCR 2716(f) Failure to maintain designated operator inspection reports and all attachments on site for 36 months ❑ V o R ❑ COS 208 CCR 2716(a-e) Failure to comply with the designated operator inspection requirements ❑ R COS 209 CCR 2715(c)(3) , Failure to maintain a copy of the " Facility Employee Training Certificate" on-site V ❑ R COS 2715(c)(4) ` 210 CCR 2715(c) Failure to provide initial training , train every 12 months, and have a trained employee present ❑ V ❑ R o COS F21 CCR 2715(c) (2) Failure to have or implement a training program approved by the UPA, at an unstaffed facility ❑ V ❑ R ❑ COS CCR 2651 ; HSC 25294 Failure to record any unauthorized release from primary containment ❑ V ❑ R ❑ COS CCR 2650(e) , 2652 Failure to notify and submit report of reportable unauthorized release or record release o V ❑ R ❑ COS CCR 2712 Failure to comply with UST operating permit conditions ❑ V ❑ R o COS 215 CCR 2715 Designated operator, service tech , or installer did not possess current certifications ❑ V o R ❑ COS 216 HSC 25281 . 5(b)(2) Failure to meet exclusion requirements for unburied fuel piping at a marina ❑ V ❑ R ❑ COS 217 HSC 25281 . 5 (b)(3) Failure to meet exemption requirements for emergency generator unburied fuel piping ❑ V ❑ R ❑ COS UST System Observations 301 HSC 25292A (a) Failure to operate UST system to prevent unauthorized releases including leaks, spills and overfills ❑ V ❑ R ❑ COS 302 CCR 2630 (d) , 2641 (a) Leak detection equipment not installed/maintained/located to detect leaks at earliest opportunity o V ❑ R ❑ COS 303 CCR 2630 (d) , 2641 (a) Failure to maintain piping to allow liquid to flow into sump (i.e. failure to remove test boots) ❑ V ❑ R ❑ COS 304 CCR 2631 (a) ; HSC Failure to construct, operate, and maintain primary containment as product-tight ❑ V ❑ R ❑ COS 25290 . 1 (c) 305 HSC 25290 . 11 25290 .21 Failed to maintain secondary containment (e.g , failure of secondary containment testing) ❑ V ❑ R ❑ COS 25291 306 HSC 25291 (a) Failure to remove, analyze, and properly dispose of water in secondary containment (pre-Jul 2003) ❑ V ❑ R ❑ COS 307 HSC 25290. 1 (c3) , Failure to keep water out of the secondary containment system (post-Jul 2003) ❑ V ❑ R ❑ COS 25290. 2 (c3) 308 CCR 2632(c) , 2634(d) , Failure of the leak detection equipment to have an audible and visual alarm o V o R o COS 2636(f) 309 CCR 2666 (b) (2) , 2636(f) Failure to have continuous monitoring that activates audible-visual alarm or stops flow at dispenser ❑ V ❑ R ❑ COS ( 1 ) 310 CCR 2636(f) (4) Failure to meet monitoring requirements in lieu of being tightness tested every 12 months ❑ V ❑ R ❑ COS 311 HSC 2636 (a) (1 ) , Monitoring system incapable of detecting leak into secondary containment (pre-Jul 2003) ❑ V ❑ R o COS 25291 (b) Page 2 of 4 Underground Storage Tank Program OR 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www. sjgov. org/EHD