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9 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 />UNDERGROUND STORAGE TANK (UST) PROGRAM INSPECTION REPORT <br />Facility 1 1 <br />Name: \j cj� <br />Facility <br />Inspection <br />Date: <br />6 --1,9'-A� <br />FacilityCERS/ <br />Address: '3'S—'A) <br />ID: 4:5;10ol�6, <br />InspectionI <br />Contact: <br />C tj <br />a t f" <br />Title: ,Phone: <br />ngw) <br />Inspection <br />Type: <br />Program: <br />Consent Given For: <br />2!Lhspection pehotols>rSampling <br />Consen4 <br />Wc- ke <br />Service Tech <br />'ic <br />Onsite: V60 <br />Exp. <br />63if"114w- Data: <br />rDesignatedgj E <br />Operator: te: <br />Service TechnicianT -;? —3 ;? <br />Manufacturer's Training: V <br />92,34- k <br />CCR = California Code of Regulations HSC = Health and Safety Code CFR = Code of Federal Regulations <br />V = Violation R = Repeat COS = Corrected on site during inspection <br />File Review <br />V R COS <br />101 HSC 25284 <br />No permit to operate (V650) <br />0 0 11 <br />102 HSC 25284(a)(3) <br />No written agreement between tank owner and tank operator to monitor the tank system (V735) <br />0 0 0 <br />103 HSC 25292.2 <br />Current financial responsibility documents not submitted (V720) <br />0 0 0 <br />104 CCR 2711 <br />UST Operating Permit Application for Facility and Tank information not submitted or current (V651) <br />El El El <br />105 HSC 25286(c) <br />Current BOE number not submitted (V652) <br />0 0 0 <br />106 CCR 2632 <br />Monitoring and response plans not current or approved by the EHD (V654) <br />0 0 Cl <br />107 CCR 2632(d)(1)(C) <br />Plot plan/site map not submitted or failed to completely show where monitoring is performed (V655) <br />El El 11 <br />108 CCR 2637(eo, <br />2638() <br />Failed to notify the EHD 48 hours prior to conducting testing (\/671) <br />0 11 0 <br />109 CCR 2637 <br />Failed to test secondary containment (V660) <br />0 0 0 <br />110 CCR 2637(e) <br />Failed to submit secondary containment test report within 30 days (V662) <br />El D 0 <br />111 CCR 2638(a) <br />Failed to test monitoring and leak detection equipment annually (V659) <br />0 D 0 <br />112 HSC 25284.2 <br />Failed to test spill containers annually (V661) <br />0 0 0 <br />113 CCR 2638(d) <br />Failed to submit monitoring system certification test report within 30 days (V823) <br />0 El 0 <br />114 CCR 2636(0 <br />Failed to perform 0.1 gph annual fine test for pressurized piping without fail safe or shut down (V663) <br />0 El El <br />115 COR 2715(a) <br />Failed to inform the EHD of a change of designated operator within 30 days (V658) <br />0 El 0 <br />116 CCR 2715 <br />Designated operator, service tech or installer did not possess current ICC certification (V717) <br />0 11 0 <br />117 HSC 25292.5 <br />Failed to conduct ELD testing on a system located within 1000' of a public well (V672) <br />0 1) 1 1 <br />118 HSC 25292.5 <br />Failed to repair and retest system due to failed ELD test (V749) <br />0 11 E) <br />119 COR 2644.1(a)(5) <br />Failed to submit ELD test results within 60 days (V669) <br />L3 0 0 <br />120 CCR 2663 <br />Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after (V666) <br />0 0 0 <br />121 CCR 2663 <br />Failed to submit tank lining certification within 30 days or to conduct proper tests (V667) <br />0 0 0 <br />122 HSC 25299 <br />Documents were falsified or misrepresented (V657) <br />0 0 1 11 <br />123 OCR 2661 <br />Permit to repair UST system not obtained (V673) <br />11-C 0 0 <br />124 CCR 2635(d) <br />Failed to submit UST Certification of Installation/Modification (V840) <br />0 11 0 <br />125 CCR 2712(f) <br />Failed to submit a written response within 30 days of receiving an inspection report (V804) <br />0 Cl El <br />126 HSC. 25404(e)(4) <br />Failed to report program data electronically (V817) <br />0 0 0 <br />On Site Records <br />V R COS <br />201 CCR 2712(b) <br />Failed to maintain alarm logs and/or records of follow up actions (V725) <br />El El 0 <br />202 CCR 2712(b) <br />Failed to maintain cathodic protection test records on site for at least 6 1/2 years (V733) <br />El El 0 <br />203 CCR 2712(b4 Failed to maintain records of mon' ori repair, lining, and upgrades on site (V732) <br />Received Inspector: Ins <br />By (initial: Phonet <br />0 0 11 <br />EHD 23-01 REV 08/07/15 Page 1 - -UST INSPECTION REPORI <br />