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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.slcehd.com <br />UNDERGROUND STORAGE TANK <br />UST PROGRAM INSPECTION REPORT <br />Facility <br />V R COS, <br />Facility <br />HSC 25284 <br />Inspection <br />Name:- <br />102 <br />Phone: <br />No written agreement between tank owner and tank operator to monitor the tank system (V735) <br />Date: <br />Facility <br />Address: (' `/ <br />HSC 25292.2 <br />Current financial responsibility documents not submitted (V720) <br />CERS <br />ID: <br />Inspection <br />Title: <br />/ <br />❑ ❑ 1 ❑ <br />Phone: <br />Contact: <br />Current BOE number not submitted (V652) <br />ILj <br />106 <br />CCR 2632 <br />InspectionI, <br />Type: d �tT / � J / <br />❑ ❑ ❑ <br />Program: <br />IX J <br />CCR 2632(d)(1)(C) <br />Consent Given For: <br />Consent <br />108 <br />CCR 2637(f), <br />2638(e) <br />.nspection hotos Sampling <br />Given By: C <br />109 <br />CCR 2637 <br />ervice Tech Ex .Designated <br />❑ ❑ ❑ <br />Exp. /Q <br />Onsite: Date: /1� <br />Failed to submit secondary containment test report within 30 days (V662) <br />Operator. <br />Date: / <br />Service Technician 3 a <br />Gi <br />/ <br />❑ ❑ ❑ <br />Manufacturers Training: % j <br />7 7 <br />Failed to test spill containers annually (V661) <br />CCR = California Code of Regulations HSC = Health and Safety Code <br />CFR = Code of Federal Regulations <br />CCR 2638(d) <br />Failed to submit monitoring system certification test report within 30 days (V823) <br />V = Violation R = Repeat <br />COS = Corrected on site during inspection <br />201 CCR 2712(b) <br />On Site Records <br />Failed to maintain alarm logs and/or records of follow up actions (V725) <br />File Review <br />V R COS, <br />101 <br />HSC 25284 <br />No permit to operate (V650) <br />Cl ❑ ❑ <br />102 <br />HSC 25284(a)(3) <br />No written agreement between tank owner and tank operator to monitor the tank system (V735) <br />❑ ❑ ❑ <br />103 <br />HSC 25292.2 <br />Current financial responsibility documents not submitted (V720) <br />❑ ❑ ❑ <br />104 <br />CCR 2711 <br />UST Operating Permit Application for Facility and Tank information not submitted or current (V651) <br />❑ ❑ 1 ❑ <br />105 <br />HSC 25286(c) <br />Current BOE number not submitted (V652) <br />❑ ❑ ❑ <br />106 <br />CCR 2632 <br />Monitoring and response plans not current or approved by the EHD (V654) <br />❑ ❑ ❑ <br />107 <br />CCR 2632(d)(1)(C) <br />Plot plan/site map not submitted or failed to completely show where monitoring is performed (V655) <br />❑ ❑ ❑ <br />108 <br />CCR 2637(f), <br />2638(e) <br />Failed to notify the EHD 48 hours prior to conducting testing (V671) <br />❑ ❑ ❑ <br />109 <br />CCR 2637 <br />Failed to test secondary containment (V660) <br />❑ ❑ ❑ <br />110 <br />CCR 2637(e) <br />Failed to submit secondary containment test report within 30 days (V662) <br />❑ ❑ ❑ <br />111 <br />CCR 2638(a) <br />Failed to test monitoring and leak detection equipment annually (V659) <br />❑ ❑ ❑ <br />112 <br />HSC 25284.2 <br />Failed to test spill containers annually (V661) <br />❑ ❑ ❑ <br />113 <br />CCR 2638(d) <br />Failed to submit monitoring system certification test report within 30 days (V823) <br />❑ ❑ ❑ <br />114 <br />CCR 2636(f) <br />Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down (V663) <br />❑ ❑ ❑ <br />115 <br />CCR 2715(a) <br />Failed to inform the EHD of a change of designated operator within 30 days (V658) <br />❑ ❑ ❑ <br />116 <br />CCR 2715 <br />Designated operator, service tech or installer did not possess current ICC certification (V717) <br />❑ ❑ ❑ <br />117 <br />HSC 25292.5 <br />Failed to conduct ELD testing on a system located within 1000' of a public well (V672) <br />❑ ❑ ❑ <br />118 <br />HSC 25292.5 <br />Failed to repair and retest system due to failed ELD test (V749) <br />❑ ❑ ❑ <br />119 <br />CCR 2644.1(a)(5) <br />Failed to submit ELD test results within 60 days (V669) <br />❑ ❑ ❑ <br />120 <br />CCR 2663 <br />Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after (V666) <br />❑ ❑ ❑ <br />121 <br />CCR 2663 <br />Failed to submit tank lining certification within 30 days or to conduct proper tests (V667) <br />❑ ❑ ❑ <br />122 <br />HSC 25299 <br />Documents were falsified or misrepresented (V657) <br />❑ ❑ ❑ <br />123 <br />CCR 2661 <br />Permit to repair UST system not obtained (V673) <br />❑ ❑ ❑ <br />124 <br />CCR 2635(d) <br />Failed to submit UST Certification of Installation/Modification (V840) <br />Cl ❑ ❑ <br />125 <br />CCR 2712(f) <br />Failed to submit a written response within 30 days of receiving an inspection report (V804) <br />❑ Cl ❑ <br />126 <br />HSC 25404(e)(4) <br />Failed to report program data electronically (V817) <br />Cl ❑ ❑ <br />201 CCR 2712(b) <br />On Site Records <br />Failed to maintain alarm logs and/or records of follow up actions (V725) <br />V R COS <br />❑ ❑ ❑ <br />202 CCR 2712(b) <br />Failed to maintain cathodic protection test records on site for at least 6 1/2 years (V733) <br />❑ ❑ ❑ <br />203 CCR 2712(b) <br />Failed to maintain records of onitoring, repair, lining, and upgrades on site (V732) <br />❑ ❑ ❑ <br />Received <br />By (initial): <br />Inspector: _ <br />Inspector <br />Phone: <br />EHD 23-01 REV 08/07/15 U - Page 1 UST INSPECTION REPORI <br />