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r r SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.s6cehd.com UNDERGROUND STORAGE TANK US PROGRAMJNPECTION REPORT Facility Facility fir] WI �i V Inspection Name: (N Phone: !(JI (T( /�jz(� I Date: Facility CERS Address: CA tM ID: Inspection - Title: contact: Inspection Program: Type: Consent Given For Consent spection hotos ampling Given By: (�(� Service Tech �f Exp. Designated Exp. Onsite: 14 Date: 16 Operator. Date: Service Technician n9 �•� I tJ -J-2-27- /� 9 � Manufacturer's Traini r L,l( l L CCR=California Code of Regulations HSC=Heaith an Safety Code CFR= de of Federal Regulations V=Violation R=Repeat COS=Corrected on she during inspection File Review V R COS 101 HSC 25284 No permit to operate(V650) ❑ ❑ ❑ 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system(V735) ❑ ❑ ❑ 103 HSC 25292.2 Current financial responsibility documents not submitted(V720) ❑ ❑ ❑ 104 CCR 2711 UST Operating Permit Application for Facility and Tank information not submitted or current(V651) ❑ ❑ ❑ 105 HSC 25285(c) Current BOE number not submitted(V6.52) ❑ ❑ ❑ 106 CCR 2632 Monitoring and response plans not current or approved by the EHD(V654) ❑ ❑ ❑ 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed(V655) ❑ ❑ ❑ 108 C�e637(f), Failed to notifythe EHD 48 hours prior to conducting testing P 9 9(V671) ❑ ❑ o 109 CCR 2637 Failed to test secondary containment(V650) ❑ ❑ ❑ 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days(V662) ❑ ❑ ❑ 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually(V659) ❑ ❑ ❑ 112 HSC 25284.2 Failed to test spill containers annually(V661) ❑ ❑ ❑ 113 CCR 263B(d) Failed to submit monitoring system certification test report within 30 days(V823) ❑ ❑ ❑ 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down(V653) ❑ ❑ ❑ 115 CCR 2715(a) Failed to inform the EHD of a change of designated operator wthln 3D days(V658) ❑ ❑ ❑ 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification(V717) ❑ ❑ ❑ 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1000'of a public well(V672) ❑ ❑ ❑ 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test(V749) ❑ ❑ ❑ 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days(V669) ❑ ❑ ❑ 120 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after(V666) ❑ ❑ ❑ 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests(V667) ❑ ❑ ❑ 122 HSC 25299 Documents were falsified or misrepresented(V657) ❑ ❑ ❑ 123 CCR 2661 Permit to repair UST system not obtained(V673) ❑ ❑ ❑ 124 CCR 2635(d) Failed to submit UST Certification of Installation/Modification(V840) ❑ ❑ ❑ 125 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report(V804) ❑ ❑ ❑ 126 HSC 25404(e)(4) Failed to report program data electronically(V817) ❑ ❑ ❑ On Site Records 4_M 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions(V725)202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 1/2 years(V733)203 CCR 2712(b) Failed to maintain records of on'ori ,repair,lining,and upgrades on site(V732)Received Inspector: InspectoBy(initiaQ: Phone: EHD 23-01 REV 08/07/15 Page 1 UST4NSPECTION REPORT 1