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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East 1 <br />Telephone: (209) 468-3420 Fax. California <br />(20 ) 468-3433 Web:: www.sigov.orgi/ehd/unitiii.htmi <br />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility <br />Name: <br />HSC 25284 <br />102 <br />HSC 25404.5 <br />Facility L <br />Contact: <br />aa <br />104 <br />Inspection <br />Type:Roukine <br />105 <br />"hMonitoring System Certification <br />(Authority HS <br />25289) <br />107 <br />Consent for: <br />n speclion <br />Sampling YPhotos <br />Panel:, \ <br />------------ <br />UST - V <br />-------------- <br />----_ - - - <br />Product�r <br />Operator: <br />On Sife Service <br />Technician: <br /># + C1 I C2 I M I Code Section <br />101 <br />HSC 25284 <br />102 <br />HSC 25404.5 <br />103 <br />HSC 25284(a)(3) <br />104 <br />HSC 25292.2 <br />105 <br />CCR 2711 <br />106 <br />CCR 2632(b) <br />107 <br />CCR 2632(d)(1)(C <br />108 <br />CCR 2637 <br />W, <br />110 <br />111 <br />1' 12 <br />113 <br />114 <br />115 <br />116 <br />117 <br />118 <br />119 <br />120 <br />201 <br />202 <br />203 <br />CCR 2638 <br />HSC 25291(f) <br />HSC 25284.2 <br />CCR 2— 6 <br />CCR 2715(,) <br />CCR 2715(b) <br />CCR 2660(k) <br />L <br />C 25292.5 <br />R 2661 <br />C 25286(a) <br />25298(b) <br />25298(c) <br />CCR 2712(b) <br />CCR 2712 <br />CCR 2650 <br />Piping <br />System: <br />installation I Complaint - ID#: <br />Granted by: �W <br />Kpressurized 1 Suction Gravity <br />a�� <br />ICC Exp. <br />ICC Exp. _ <br />Date: 'r 6 — <br />Z!F_j <br />Pho <br />Other. q�GQ//� <br />Title: <br />Overfill <br />Prevention: Mechanical <br />--1------------- } - - - - ------- <br />�Audibie/visual <br />Violations: M1 -Release Detection M2 -Release Prevention M3 -Both <br />Training: <br />VIOLATIONS <br />I Code; CCR = Califorr <br />Class 2 violation: M = <br />JH: <br />permit to operate <br />ating fees not paid <br />greement between the person that the operating permit was issutanks stem <br />Current financial responsibility documents not on file with the Environmental Health Department (EH } <br />Current Unified Program Consolidated Forms not on file with the EHD (Facility and tank forma) <br />Monitoring Program (Monitoring & Response Plans) is not current or approved by the EHD <br />Plot plan/site map not submitted or fails to completely show where monitoring is performed <br />Secondary containment: (a) test not performed; (e) test report not submit ed within 30 days; (f) test notificatio <br />not rovidee to the EHD at least 48 hours rior to conductin the test <br />Monitoring equipment certification: (a) not performed annually; (d) test report not submitted within 30 days; <br />(e) test notification not provided to the EHD at leas 48 hours prior to conducting an installation, repair, <br />replacement, calibration, or certification -6 <br />Annual line leak detector test not performed <br />Annual spill containment testing not performed (M7 <br />Annual fine tightness test not performed if positive shutdown or fail safe not present <br />Failed to inform the EHD of a change of designated operator within 30 days (M1; <br />Designated operator does not possess a current 1CC CA UST System Operator certification <br />Repair for tank or piping not tested for tightness after completion of the repair pursuant to <br />ermit conditions (Mz) <br />Enhanced leakdetection (ELD}testing not <br />failures not re aired performed on a system located within 100flof p <br />' ublic well, or <br />and retested <br />Permit to repair UST system not obtained <br />Operational permit not amended when UST storage and/or monitoring system changed <br />Permit to temporarily close UST system not obtained <br />Permit to close UST system not obtained <br />C)e site Records �. , <br />Maintenance &monitoring records not maintained 3 years, cathodic protection records for 6 '/z years, written <br />performance claims pertaining to release detection systems for 5 years, or records of repairs, linings, and <br />upgrades for the life of the tank. Monitoring records include: (1) date and time of all monitoring or sampling; <br />(2) monitoring equipment calibration and maintenance records; (3) results of any visual observations; (4) <br />results of sample analysis performed a fab or in the field; (5) logs of all readings of gauges or other monitoring <br />equipment, round water elevations, or other test results; 6 results of invent o read1 s and reconciliations <br />Monitoring plan, response plan, and/or operating permit and all conditions not onsite <br />Unauthorized release that: (c) did not escape seoondary containment and cleaned up within eight hours (M1) <br />was not recorded; (e) escaped secondary containment, not cleaned up after eight hours, or a sudden foss of <br />product was not re orted to the EHD within 24 honrc <br />EHD 23-02 Rev 9/3111 <br />UST INSPECTION REPORT <br />