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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sicehd.com UNDERGROUND STORAGE TANK UST PROGRAM INSPECTION REPORT 1 � �1 Facility Inspection Facility NL�t l'� MarL Phone: Date: Gil Y' Name: Facility rII __ }7l ID:yA r I,. Address: "JW 1 V(ISc \IV e --'1 rl Title: n , ,.r,�eK-� Phone: Inspection ,�`1 (�,�Y Contact: vv Program: I / Inspection a _ l/�19-r Type: C'�'CtjnV Consent Given For: Consent Inspection hotos Sampling Given By: I� wner7 Designated J1/1f�Exp. Service Tech ��„ ' ,r n/`_„ Date: Operator. tm f r 1 V Date: Onsite: !�� K- A Service Technician Manufacturer's Training: CCR=California Code of Regulations HSC=Health and Safety Code CFR Code V= ons ViolatiofrFederal R=Repeats COS=Corrected on site 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 25286(c) Current BOE number not submitted(V652) ° ° ° 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 CCR 2637(f), Failed to notify the EHD 48 hours prior to conducting testing(V671) ° ° ° 2638(e) 109 CCR 2637 Failed to test secondary containment(V660) ° 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 2638(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(V663) ❑ ❑ ° 115 CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 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) 0 0 0 123 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 i HSC 25404(e)(4) Failed to report program data electronically(V817) On Site Records. V R COS 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 monitoring,repair,lining,and upgrades on site(V732) ❑ ❑ ° Received Inspector. V -- Inspector p O By(initial): (V' Phone: p EHD 23-01 EV 08/07/15 Page 1 UST INSPECTION REPORT