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San Joaquin County Environmental Health Department 1868 East Hazelton Avenue,Stockton, California 95205-6232 Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sigov.oLg/ehd Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: `1 �-`l i--F PRC %'_'o ' 1 016) i71 211'71) Facility Address: CERS ID: 101842 S Hl, RL,=,N RL) '4-1\ ,N��Ji ;ANIP CA :i5231 Inspection Contact: Title: —]—Fho—n-;7 Inspection Type: Program: ROUTINE INSPECT luN Op&,itinj Poimit 2361 - U1,I' I-A(,'ILIFY Consent For: Consent Given By: X Inspection X< Photos Sam2les Joy Kachidoiiaii. LHS Manages Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: "Ohn Puunlal 1 01!26,2013 Stephanie Murphy "J Ls 2 Service Technician Manufacturer's Training: VIM1 12.30 13 'Veeder Root. 07 19119 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 onspecitof File Review 101 HSC 25284 No permit to operate V R =1- 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 P COS 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan =V R COS 106 CCR 2632(d)(2) Failed to have an approved UST response plan =V R COS 107 CCR 2632(d)(1)(C) Plot planisite map not submitted or failed to completely show where monitoring is performed ■V a R COS 108 CCR 2637(f),2638(e) Faded to notify the EHD 48 hours prior to conducting testing V R COS 109 CCR 2637 Faded to test secondary containment V R COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days V R COS Ill CCR 2638(a) 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(d) Failed to submit monitoring system certification test report within 30 days V R OS 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 designated operator identification or change 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 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after V R Ck-)c 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests V R COS 119 HSC 25299 Documents were falsified or misrepresented V R 120 CCR 2635(d) Faded to submit UST Certification of Installation/Modification V R (7(1", 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report a V a R COF 122 CCR 26310) Failure to submit UST system component statement of compatibility for substance stored V R CO� On Site Records 201 CCR 2712(b) Failed to maintain alerm logs and/or records of follow up actions a V a R rnc 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 112 years V R ((0)ir 203 CCR 2712(b) Failed to maintain records of monitoring,repair,lining,and upgrades on site V P cn!; FA000689e PROS is scone. EHD 23-01 Rev O/22/16 page I Of 5 Underground Storage Tank PfN,,,, (,r-