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,■. San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, California95205-6232 Telephone. (209) 468-3420 Fax: (209) 468-3433 Web. www.sigov.org/ehd Underground Storage Program i i,Report Facility Name: HSC 25284 No permit to operate Facility Phone: ❑ V Date: ❑ COS 102 HSC 25284(a)(3) '20T 932-13' ❑ V Facility Address: ❑ COS 103 HSC 25292.2 CE S ID: _ x^ ❑ V ❑ R ❑ COS 1a.. 18074 Inspection Contact: UST Operating Permit Application for Facility and Tank information not submitted or current Title: ❑ V ❑ R Phone: 105 HSC 25286(c) Current BOE number not submitted ❑ V ❑ R Inspection Type: 106 Program: Monitoring and response plans not current or approved by the EHD I! f t f t �. P' t n f i'L ❑ R ❑ COS z is r i . < ,a 3 , y _ _ - _ Consent For: ❑ R I Consent Given By: 108 CCR 2637(f), 2638(e) <_ Inspection I Photos Samples I ,.1, v(-- Hind,,-,, ., Fs - . .f" na e!, ❑ COS Service Technician Onsite: Exp. Date: Designated Operator: Exp. date: ❑ V ❑ R ❑ COS 110 IService Technician Manufacturers Training: I VP a ap 5 t i / P .. f ,,. t 117 s s�. r,�€'� t ,,. �, V = Violation R = Repeat violation COS = Corrected on site during inspection 101 HSC 25284 No permit to operate ❑ V ❑ R ❑ COS 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system ❑ V ❑ R ❑ COS 103 HSC 25292.2 Current financial responsibility documents not submitted ❑ V ❑ R ❑ COS 104 CCR 2711 UST Operating Permit Application for Facility and Tank information not submitted or current ❑ V ❑ R ❑ COS 105 HSC 25286(c) Current BOE number not submitted ❑ V ❑ R ❑ COS 106 CCR 2632 Monitoring and response plans not current or approved by the EHD ❑ V ❑ R ❑ COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed ❑ V ❑ R ❑ COS 108 CCR 2637(f), 2638(e) Failed to notify the EHD 48 hours prior to conducting testing ❑ V ❑ R ❑ COS 109 CCR 2637 Failed to test secondary containment ❑ V ❑ R ❑ COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days ❑ V ❑ R ❑ COS 111 CCR 2638(x) Failed to test monitoring and leak detection equipment annually ❑ V ❑ R ❑ COS 112 HSC 25284.2 Failed to test spill containers annually ❑ V ❑ R ❑ COS 113 CCR 2638(4) Failed to submit monitoring system certification test report within 30 days ❑ V ❑ R ❑ COS 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down ❑ V ❑ R ❑ COS 115 CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days ❑ V ❑ R ❑ COS 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification ❑ V ❑ R ❑ COS 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1 000'of a public well ❑ V ❑ R ❑ COS 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test ❑ V ❑ R ❑ COS 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days ❑ V ❑ R ❑ COS 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 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑ V ❑ R ❑ COS 122 HSC 25299 Documents were falsified or misrepresented ❑ V ❑ R ❑ COS 123 CCR 2661 Permit to repair UST system not obtained ❑ V ❑ R ❑ COS 124 CCR 2635(d) Failed to submit UST Certification of Installation/Modification ❑ V ❑ R ❑ COS 125 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ❑ V ❑ R ❑ COS Received byInspector: (initial): 3 j"111,, A 1(209" x REHS Phone: (f 09" t... 311 ate: