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SAN JOAQUIN COUNTY . <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, California 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:WWW.Sigov org/ehd/tinitiii html <br /> UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br /> pth 't <br /> lity Facility <br /> e:Shy-� /7 Add -7,1/1 -{y Inspection <br /> ity �• ll/ . Date: <br /> act: W" /. Title: Phone: <br /> ctlon outine 'aPooniloring Systemm Certi i tion a Installation L <br /> : t Complaint-ID#: uOther: <br /> ority HS 25289) <br /> ent for: _ spection ampling hotos Granted by: ��� Title: <br /> toring PipingOvertill <br /> l: S -�� Syse : pressurized 11 Suction U Gravity Mechanical ❑Audible/visual <br /> Prevention: <br /> ST ' nduct `� __._._.___.___ _ ___._____.__ __._._._._.___nated ICC Ex .tor: (�/(�O Date: p 3 Violations: F M7-Release Detection ❑M2-ReleasePrevention ❑M3-Both <br /> ite Service ICC Exp. ` Manufacturer'sician: Date: V�,�j �i Training: <br /> VIOLATIONS <br /> # C1 C2 M Code Section HSC=California Health and Safety Code;CCR=California Code of Regulations <br /> Cl =Class 1 violation:C2=Class 2 violation;M=Minor violation <br /> File.Review <br /> 101 HSC 25284 No permit to operate <br /> 102 HSC 25404.5 Annual operating fees not paid <br /> 103 HSC 25284(a)(3) No written agreement between the person that the operating permit was issued to and the tank operator to <br /> monitor the tanks stem <br /> 104 HSC 25292.2 Current financial responsibility documents not on file with the Environmental Health Department(EHD) <br /> 105 CCR 2711 Current Unified Program Consolidated Forms not on file with the EHD(Facility and tank form) <br /> 106 CCR 2632(b) Monitoring Program(Monitoring&Response Plans)is not current or approved by the EHD <br /> 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or fails to completely show where monitoring is performed <br /> 108 CCR 2637 Secondary containment:(a)test not performed;(e)test report not submitted within 30 days;(f)test notification <br /> not provided to the EHD at least 48 hours prior to conductingthe test <br /> Monitoring equipment certification:(a)not performed annually;(d)test report not submitted within 30 days; <br /> 109 CCR 2638 (e)test notification not provided to the EHD at least 48 hours prior to conducting an installation,repair, <br /> replacement,calibration,or certification <br /> 110 HSC 25291(f) Annual line leak detector test not performed (M1) <br /> 111 HSC 25284.2 Annual spill containment testing not performed <br /> 112 CCR 2636(0(4) Annual line tightness test not performed if positive shutdown or fail safe not present (M1) <br /> 113 CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days <br /> 114 CCR 2715(b) Designated operator does not possess a current ICC CA UST System Operator certification <br /> 115 CCR 2660(k) Repair for tank or piping not tested for tightness after completion of the repair pursuant to (M2) <br /> ermit conditions <br /> 116 HSC 25292.5 Enhanced leak detection(ELD)testing not performed on a system located within 1000'of public well,or <br /> failures not repaired and retested <br /> 117 CCR 2661 Permit to repair UST system not obtained <br /> 118 HSC 25286(a) Operational permit not amended when UST storage and/or monitoring system changed <br /> 119 HSC 25298(b) Permit to tempclose UST system nobtained <br /> 120 HSC orarily ot 25298(c) Permit to close UST system not obtained <br /> On Site Records <br /> Maintenance&monitoring records not maintained 3 years,cathodic protection records for 6%years,written <br /> performance claims pertaining to release detection systems for 5 years,or records of repairs,linings,and <br /> 201 CCR 2712(b) 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 lab 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 nventory readings and reconciliations <br /> 202 CCR 2712(i) Monitoring plan,response plan,and/or operating permit and all conditions not onsite <br /> zed <br /> Unauthorirelease that:(c)did not escape secondary containment and cleaned up within eight hours (M1) <br /> 203 CCR 2650 was not recorded;(e)escaped secondary containment,not cleaned up after eight hours,or a sudden loss of <br /> product was not re orted to the EHD within 24 hours <br /> Inspector: Received By: <br /> Title: <br /> EHD 23-02 Rev �Page 1 UST INSPECTION REPORT <br />