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VEL) <br /> San Joaquin County MAR 0 2 2016 <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, Califomia9520"232 ENVIRONMENTAL <br /> Telephone.(209)468-3420 Fax.(209)466-3433 Web:www.Sioov or_y/ehd aZ,�!rt-j^u-06 P T tRr_Nl <br /> Facility Name; <br /> Underground Storage Tank Program Inspection Report <br /> Facility Phone: Date: <br /> Facility Address: <br /> CERS ID- <br /> Ins tion <br /> D;inspection Contact: Title: <br /> Phone; <br /> Inspection Type <br /> Program: <br /> Consent For: <br /> Conserv Given sy: <br /> Inspection Photos Sam les <br /> Service Technician Onsite: Exp.Date: Designated Operator: <br /> Exp.Date: <br /> Service Technician Manufacturer's Training <br /> =Ca r ornia e o egu a ions = h an afety Code = o era Regulations <br /> V=Violation R=Repeat vioUion cos.Corralled on rile during inspection <br /> Fite Review <br /> 101 HSC 25264 No permit to operate <br /> OV oR uCOS <br /> 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system r2 V a R o COS <br /> 103 HSC 25292.2 Current financial responsibility documents not submitted <br /> OV cR uCOS <br /> 104 CCR 2711 UST Operating Permit Application for Facility and Tank information not submitted or current <br /> w ;iR -COS <br /> 105 HSC 25286(c) Current BOE number not submitted <br /> o uR oCOS <br /> 106 CCR 2632 Monitoring and response plans not current or approved by the EHD <br /> -- 13v c.r R o COS <br /> 107 CCR 2632(d)(1)(C) Plot plan/site map not Submitted or failed to completely show where monitoring ie performed <br /> u oR uCO3 <br /> 108 CCR 2637(f),2638(e) Failed to notify the EHD 48 hours prior to conducting testing <br /> r3V uR oCOS <br /> 109 CCR 2637 Failed to test secondary containment <br /> t3 L;R r-COS <br /> 110 CCR 2637(e) Failed to submit secondary containment teat report within 30 days <br /> o u L,COS <br /> 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually <br /> cV oR nCOS <br /> 112 MSC 25284.2 Failed to test spill containers annually <br /> uV j es COS <br /> 113 CCR 2636(d) Failed to submit monitoring system cerMcatlon test report within 30 days <br /> n n cCOS <br /> 114 CCR 2636(1) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down <br /> c in ❑COS <br /> 115 CCR 2715(a) Failed to Inform the EHD of a change of designated operator within 30 days 0 V c R n COS <br /> 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification <br /> o oR uCOS <br /> 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1000'of a public well <br /> eV aR Li COS <br /> 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test <br /> u -,R cCOS <br /> 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days o V in R e COS <br /> 120 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after ,V ❑R ❑COS <br /> 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests u V u R n COS <br /> 122 HSC 25299 Documents were falsified or misrepresented o V o R n COS <br /> 123 CCR 2661 Permit to repair UST system not obtained V n R ❑COS <br /> 124 CCR 2635(d) Failed to submit UST Certification of InstallationlModification ❑V ❑R e COS <br /> 125 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report <br /> oV rR nCOS <br /> 126 HSC 25404(e)(4) Failed to report program data electronically c V u R c COS <br /> Page 1 of 6 <br />