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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sicehd.com <br />UNP.,..STORAGE TANK(UST)-PRO60Wt REPORT <br />HSC 25284 <br />: <br />FileReview <br />No permit to operate (V650) <br />V R COS' <br />❑ ❑ ❑ <br />,SPECTION <br />HSC 25284(a)(3) <br />Facility <br />�� <br />�i7 <br />Facility <br />Phone'—X 15 <br />Inspection <br />Date: <br />Name: �,� C <br />❑ ❑ ❑ <br />104 <br />CCR 2711 <br />Facility <br />Address: l sort. <br />❑ ❑ ❑ <br />j <br />CERS <br />ID: <br />Inspection <br />❑ ❑ ❑ <br />Title: <br />CCR 2632(d)(2) <br />Phone: <br />Contact: <br />107 <br />CCR 2632(d)(1)(C) <br />Plot plan/site map not submitted or failed to completely show where monitoring is performed (V655) <br />❑ ❑ ❑ <br />Inspection f�s� <br />CCR 2637(f), <br />2638(e) <br />Failed to notify the EHD 48 hours prior to conducting testing (V671) <br />Program: <br />Type: i v... <br />CCR 2637 <br />Failed to test secondary containment (V660) <br />Cl ❑ ❑ <br />Consent Given For: <br />Consent <br />Failed to submit secondary containment test report within 30 days (V662) <br />L <br />Inspection Photos ❑ Sampling <br />Given By: <br />Failed to test monitoring and leak detection equipment annually (V659) <br />❑ ❑ ❑ <br />Service Tech <br />Onsite: )Jx �r rfi� <br />Exp. 1 <br />Date: / /&� <br />Designated Exp. <br />Operator: �/� �_ Date: <br />Service Technician V� <br />Manufacturer's Training: ! ' <br />V ✓�'I � <br />ct <br />I J % � S�rrr <br />ZCCR <br />= California Code of Regulations H C = Health and Safety Code <br />CF = deo Federal Regulations <br />114 <br />CCR 2636(f) <br />V = Violation R = Repeat COS ec ed on site during inspection <br />101 <br />HSC 25284 <br />: <br />FileReview <br />No permit to operate (V650) <br />V R COS' <br />❑ ❑ ❑ <br />102 <br />HSC 25284(a)(3) <br />No written agreement between tank owner and tank operator to monitor the tank system (V735) <br />❑ ❑ ❑ <br />103 <br />HSC 25292.2 <br />Current financial responsibility documents not submitted (V720) <br />❑ ❑ ❑ <br />104 <br />CCR 2711 <br />UST operating permit application for facility and tank information not submitted or current (V651) <br />❑ ❑ ❑ <br />105 <br />CCR 2632(d)(1) <br />Failed to have an approved UST monitoring plan (V852) <br />❑ ❑ ❑ <br />106 <br />CCR 2632(d)(2) <br />Failed to have an approved UST response plan (V853) <br />❑ ❑ 1 ❑ <br />107 <br />CCR 2632(d)(1)(C) <br />Plot plan/site map not submitted or failed to completely show where monitoring is performed (V655) <br />❑ ❑ ❑ <br />108 <br />CCR 2637(f), <br />2638(e) <br />Failed to notify the EHD 48 hours prior to conducting testing (V671) <br />❑ ❑ ❑ <br />109 <br />CCR 2637 <br />Failed to test secondary containment (V660) <br />Cl ❑ ❑ <br />110 <br />CCR 2637(e) <br />Failed to submit secondary containment test report within 30 days (V662) <br />❑ ❑ ❑ <br />111 <br />CCR 2638(a) <br />Failed to test monitoring and leak detection equipment annually (V659) <br />❑ ❑ ❑ <br />112 <br />HSC 25284.2 <br />Failed to test spill containers annually (V661) <br />❑ ❑ ❑ <br />113 <br />CCR 2638(d) <br />Failed to submit monitoring system certification test report within 30 days (V823) <br />❑ ❑ ❑ <br />114 <br />CCR 2636(f) <br />Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down (V663) <br />❑ ❑ ❑ <br />115 <br />CCR 2715(a) <br />Failed to inform the EHD of designated operator identification or change within 30 days (V658) <br />❑ ❑ ❑ <br />116 <br />CCR 2715 <br />Designated operator, service tech or installer did not possess current ICC certification (V848) <br />❑ ❑ ❑ <br />117 <br />CCR 2663 <br />Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after (V666) <br />❑ ❑ ❑ <br />118 <br />CCR 2663 <br />Failed to submit tank lining certification within 30 days or to conduct proper tests (V667) <br />❑ ❑ ❑ <br />119 <br />HSC 25299 <br />Documents were falsified or misrepresented (V657) <br />❑ ❑ ❑ <br />120 <br />CCR 2635(d) <br />Failed to submit UST Certification of Installation/Modification (V840) <br />❑ ❑ ❑ <br />121 <br />CCR 2712(f) <br />Failed to submit a written response within 30 days of receiving an inspection report (V804) <br />❑ ❑ ❑ <br />122 <br />CCR 2631 Q) <br />Failure to submit UST system component statement of compatibility for substance stored (V721) <br />❑ ❑ ❑ <br />EHD 23-01 REV 07/28/16 _ Page 1 UST INSPECT ION REPORT <br />.. . . . ....:... ... .... =„ : OnSife <br />U <br />201 <br />CCR 2712(b) <br />Failed to maintain alarm logs and/or records of follow up actions (V725) <br />❑ <br />❑ ❑ <br />202 <br />CCR 2712(b) <br />Failed to maintain cathodic protection test records on site for at least 6 1/2 years (V733) <br />❑ <br />❑ ❑ <br />203 <br />CCR 2712(b) <br />Failed to maintain records of monitoring, repair, lining, and upgrades on site (V732) <br />❑ <br />❑ ❑ <br />204 <br />CCR 2712(1) <br />Current monitoring plan approved by the EHD not found on site (V734) <br />❑ <br />❑ ❑ <br />205 <br />CCR 2712(i) <br />Failure to have an approved UST response plan available onsite (V654) <br />❑ <br />❑ ❑ <br />206 <br />CCR 2712 <br />Failure to comply with UST operating permit conditions (V738) <br />❑ <br />207 <br />HSC 25294 <br />Failed to record unauthorized release from primary containment (V737) <br />11 <br />Ell H11 <br />Received <br />By (initial): <br />Inspector: <br />G�L� Sj <br />Inspector <br />Phone: <br />--z <br />EHD 23-01 REV 07/28/16 _ Page 1 UST INSPECT ION REPORT <br />