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SAN JOAQUIN COUNTY
<br /> ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 1868 Fast Hazelton Avenue, Stockton, Califomia 95205-6232
<br /> Telephone:(209)468-3420 Fax:(209)488-3433 web:www.sjgov.cra/ehd
<br /> UNDERGROUND STORAGE TANK(UST)PROGRAM INSPECTION REPORT
<br /> F`�'Im Loves County Store#223 EAdrdlr" 1553 Colony Drive, Ripon Inspection Aug 12, 2014
<br /> Name
<br /> Conte Jesse Diaz Title Phone:Manager P'1Ofe 405-687-1060
<br /> Inspection X Routine )3(Monitoring System Certification D Installation D Complaint—ID* 0 Other
<br /> Type-
<br /> (Authority HSC 25289)
<br /> Consentfor Xinspection XSampling XPhotos G,antedby:Mr. Williams Title:
<br /> Mlonn9 Veeder-Root TLS-350 Piping )K Pressurized OSuction ❑GraOverfill
<br /> XMechanucd 0Audiblefvisual
<br /> panel:
<br /> � vItyPrevention:
<br /> y _usr-- - -�-- -- --- - - - - -. 4._ 5----- ------- - - - - - -- -- - - -. _ _ - - - -
<br /> Product 87-octane 91-actane 87-octane DSL DSL
<br /> Designated Zane Nimmo 1
<br /> CC EV
<br /> Operator3-3-2016' violatons, DM,-Relea9eDetection OW-ReleasePmvention 39(M3-tom,
<br /> on Site service ICC Exp. Manufacturers VMI: 11-12-15 VR: Y�
<br /> Technician, Felix Ramirez taste_ 3-3-16 Training
<br /> VIOLA-noNs
<br /> 0 C7 C2 141 Coda Sodion HSC=Califamia Hearth and CCR m Califorrtia Gado of R ulaGonq
<br /> Gt=Class 1 violetan:C2=Clams 2 vialaWn;M=Mouxvfo awn
<br /> F�";O.S�� u�"'�'�'�ti.�vy .` ,t .i�S^f{. .:.=4',yiJ„% tt� ',dLf�.�.+'i4�•�i$! .'gf��.'�Jr �f�°5��.a ..i�l.,_.,. "%or,si.,, Qf,,l:r -;P:ji?r%a:�� '�'I' w;YM1.ti.��X
<br /> 101 HSC 25284 No permit to 2peraba
<br /> 102 HSC 25404.5 Annual operating fees not paid
<br /> 103 HSC 252Wax3) No written agraament between the person that the operating pannit was issued to and the tank operator to
<br /> monitor the lank s stem
<br /> 104 HSC 25292.2 Current financial responsibiFfy documents not on fl!e with the Enviraxnental Health Department(EMD)
<br /> 105 CCR 2'711 Gurrartt Unified Program t,Onsolidated Forms not on fila with the EHD Facility and tank form)
<br /> 10 8 X CCR 2SM(b) Monitoring Program(tiAonitoring$,Response Plans}is not aarent or approved by Ura t
<br /> 107 CCR 2ti32(d)(11)(C) Plot P�� map not subm tract or falls to cAm leiery show where monitnr(ng Is performed ed
<br /> 108 X CCR 2637 Secorrdary catxairtrnent:(a)test not performed:(e)test repoA not submitted wittin 30 days:(f)test notification
<br /> not provitled to the EHD at feast 48 betas or to canductln the test
<br /> Monitoring equipment certification:(a)not performed annually (d)test report not submitted within 30 days;
<br /> 109 CCR Zt338 (e)test notification not provided to the EHD at least 48 hours prior to conducting an installation,repair,
<br /> repL%Dement,cafibratton.or certification
<br /> 110 HSC 25291(f) Annual line leak detector test not performed (�t)
<br /> 111 HSC 25254-2 Annual spin containment testing not performed
<br /> 112 CCR 2838(h}(4) Annual fine tightness test not periomled if iltve shutdown or fail safa not present (M1)
<br /> 113 CCR 271 8 Failed to inform the EHD of a change of d®sfgnated operrtrtor wittdn 30 days
<br /> 114 CCR 2715(b) Designated operator does not possess a current ICG CA UST system operator certificatiati
<br /> 115 CCR 26g0((t} Repair for tank or piping riot tested for Ightness after completion of the repair pursuant to (M2)
<br /> emit conditions
<br /> 116 HSC 25292 5 Enhanced leak detection(EtD)testing not performed on a system located within 1000'of public well,ar
<br /> failures trot repaired and retested
<br /> 117 CCR 2661 Permit to repair UST system not obtained
<br /> 11$ H5C 25288{a} operational permit not amended when UST storage and/or morAlnting system changed
<br /> 119 1HSC 25298(b) Permit to temporanly close UST system not obtained
<br /> 120 HSC 25298(c) permit to dose UST system not obtained
<br /> .rn: +c;:y:}. - .N.�.:r> rx" ..i - ,•4-�:.r'ti x.,5'.'1`. if�•',�'c'�. �h�'"..E. a'i:. .".�y4.Y�<�. :.'i�',.teiy:+c�yi.7��F<t''S,
<br /> v-.�3',`k:'`'�i=,�i..y°.;9.id1Ym!r5a. �:�1:•`�,`,.k}_:Y:�S`o`.tC�MC,l.?ti�,��J:�,r�'._��li�afkr<�'b'.Dry:.:.'�ic' :?'' .. .-.. .: �,., n�.irnJr'.=:.'cSl.:a...r..,,1:.,�`ii:,_'i .rv.`�,..a.var
<br /> N.
<br /> Maintpnatnce&monitoring records not maintained 3 years,cathodic pmteClion recaords for 6 34 years,written
<br /> performance dawns pertaining to release detection systems for 5 Years,or ra mrds of repairs,linings.and
<br /> 2D1 CCR 2712(b) upgrades for the fife of the tank. Monitoring records include:(1)date and tine of ail mordwring or sampling;
<br /> (2)monitoring equipment calibr8tion and maintenance records;(3)results of any visual observations;(4)
<br /> results of sample analysis performed a tab or in ttra field;(5)logs of all readings of gauges or other monitoring
<br /> equipmem round water elevations,or other test results: 8 results ofiriventory.readi s and reconciliations
<br /> 202 CCR 2712(i. Monituring plan,response plan,andfor operating permit and all conditions not onsite
<br /> Unauthorized release trial(c)did not escape secondary containment and cleaned up within eight tours (Ito)
<br /> 203 COR 2850 was not recorded;(e)escaped secondary containment,not cleaned up after ei()ht hours,or a sudden loss of
<br /> product was not fled to the EHD within 24 betas
<br /> Inri Re¢tact BY- Title:
<br /> Elena Manzo (209) 953-7699
<br /> EHD 23.02 Rev 04119!12 Pargt 1 UST INSPECTION REPORT
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