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rA SD San Joaquin County SEP 2T 20 Environmental Health Departmentt. �lr;R 1868 East Hazelton Avenue, Stockton, Ca�ornia,4605 � � Telephone:(209)468-3420 Fax:(209)468-34RjWW `' j�dv�`r lehd I Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: KAISER FOUNDATION- MANTECA (209)825-3848 July 08, 2016 Facility Address: CERS ID: 1777 W YOSEMITE AVE, MANTECA, CA 95337 10181559 Inspection Contact: Title: Phone: Sam Corbin Chief Engineer (209)629-9919 Inspection Type: Program: ROUTINE INSPECTION -Operating Permit 2361 - UST FACILITY Consent For: Consent Given By: N Inspection N Photos 0 Samples Sam Corbin, Chief Engineer Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: David Walker 12/28/2017 Gabriel Martin 05/21/2018 Service Technician Manufacturer's Training VR:, 11/20/16; VMI:, 02/02/17 CCR=California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations V=Violation R=Repeat violation COS=Corrected on site during inspectio File Review 101 HSC 25284 No permit to operate n V n R n COS 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system o V o R u COS 103 HSC 25292.2 Current financial responsibility documents not submitted ■V o R o COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current u V u R u COS 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan n V n R n COS 106 CCR 2632(d)(2) Failed to have an approved UST response plan o V u 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 o R o COS 109 CCR 2637 Failed to test secondary containment n V o R n COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days u V u R u COS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually n V o R u COS 112 HSC 25284.2 Failed to test spill containers annually o V o R o COS 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days u V u R u 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 u COS 115 CCR 2715(a) Failed to inform the EHD of designated operator identification or change within 30 days o V o R o COS 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification u V u R o COS 117 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after u V ❑R u COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests u V ❑R ❑COS 119 HSC 25299 Documents were falsified or misrepresented ❑V o R o COS 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification u V n R n COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ❑V u R u COS 122 CCR 26310) Failure to submit UST system component statement of compatibility for substance stored o V n R ❑COS On Site Records 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions n V u R u COS 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 1/2 years o V n R ❑COS 03 CCR 2712(b) Failed to maintain records of monitoring,repair,lining,and upgrades on site n V u R n COS Page 1 of 4