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ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 Cast Main Su.-t, Stockton, C_aiiiorrtia X5202-302 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.siaov.orgiehu`iuniiin.ilimi <br /> UNDERGROUND STORAGE TANK(UST) PROGRAM iNSPEC tiON REFUR i <br /> Facility TFcitiiy inspection Jun 5, 2012 <br /> Name- Safeway#2600 dre s: 1987 West 11 th Street, Tracy l��at�: <br /> Facility <br /> Contac-;,-. Ron LNernetta C/Dottie G Tale: Safety EnviroSupervisors 622389-7937 <br /> inspection <br /> spection XRoutine $(Monitoring System Certification Installation n Complaint-ID# El Other: <br /> Type: <br /> (Authority HSC 25289) <br /> Consent for: }(Inspection XSampling XPhotos Granted by: C I Tdle Ahr <br /> Monitoring Veeder-Root TLS-350 Gravity Overfill <br /> Panel: System: p(Pressurized _ Suction ;Gravi Prevention: H Mechanical XAudiblelvisual <br /> usT 1 2 Product - - - - - 87octane- ----------- -------------- -----DSL - - - - - - - - - - - - - - - - [_____3 <br /> 91-octane ----] - - - - - <br /> Designated R anCase ICC Exp. 0912/0712 Violations: ❑M1-Release Detection i:1 M2-Release Prevention ❑M3-Both <br /> /DaveThoma <br /> Operator: y y Date: <br /> On Site ServiceICC . Manufacturer's <br /> Technician: Randy Wilkerson DateExp: 051913 Training: VMI 050513 VR4 031814 <br /> VIOLATIONS <br /> # I C1 C2 M Code Section HSC=California Health and Safety Code CCR=Califomia Code of Regulations <br /> C1=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 I 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 conducting the test <br /> Monitoring equipment certification:(a)not performed annually;(d)test report not submitted within 30 days; <br /> 109 CCR 2638 (a)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(f)(4) Annual line tightness test not performed if positive shutdown or fail safe not present (Mi) <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 /> permit 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 temporarily close UST system not obtained <br /> 120 HSC 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 V2 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 arid tide of all monituiing or sampling;( ) (2)monitoring equipment-a!;hration 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,ground water elevations or other test results 6 results of inventory readings and reconciliations <br /> 202 CCR 2712(i) Monitoring plan,response plan,and/or operating permit and all conditions not onsite <br /> Unauthorized release that:(c)did not escape secondary containment and cleaned up within eight hours (M1) <br /> 203CCR 2650 was not retarded,tc,escaped secondary cofit.,1„ -leone,,up a�I etgIl:Fours,or a su.,,.�r,IW��:,1 <br /> roduet was not reported to the HD within 24 hours <br /> Inspector. Re eivFl Title <br /> Thuy Tran (209) 468-8257 <br /> EHD 23-02 Rev 09/01/11 Page UST INSPECTION REPORT <br />