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Adak Ak 1W San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone. (209)468-3420 Fax:(209)468-3433 Web:www.sjciov.o[g/ehd Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: i V7 IVI i �i()1 1,4 —inner i r Facility Address: CERS ID: i ;'j e'+ j j',Jl ftI t-<rAAI Y l.ti 11:)11 f 0 Inspection Contact- Title: Phone: Inspection Type: Program: jkj -30 1 r I L i I Y Consent For: Consent Given By: Inspection Photos Samples 2-0 Service Technician Onsite Exp.Date: Designated Operator: Exp.Date: 0q;K(-;1d "J" uolz I Service Technician Manufacturer's Training ';'-' 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 inspection File Review 101 HSC 25284 No permit to operate Li V c R u COS 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system Ei V o R c COS 103 HSC 25292.2 Current financial responsibility documents not submitted o V n R o COS 104 CCR 2711 UST Operating Permit Application for Facility and Tank information not submitted or current o V o R o COS 105 j HSC 25286(c) Current BOE number not submitted o V o R Li COS 106 CCR 2632 Monitoring and response plans not current or approved by the EHD u V D R o COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed o V o R n COS 108 CCR 2637(f),2638(e) Failed to notify the EHD 48 hours prior to conducting testing o V o R o COS 109 CCR 2637 Failed to test secondary containment o V o R o COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days o V o R Ei COS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually o V Ei 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 o V o R Ei COS 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down uV Ei R o COS 115 CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days o V o R o COS 116 CCR 2715 Designated operator,service tech or installer did not possess current[CC certification o V o R o COS 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1000'of a public well iiV o R o COS 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test o V o R o COS 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days u V o R o COS 120 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after Ei V o R o COS 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests D V o R o COS 122 HSC 25299 Documents were falsified or misrepresented o V o R o COS 123 CCR 2661 Permit to repair UST system not obtained o V o R ci COS 124 CCR 2635(d) Failed to submit UST Certification of Installation/Modification o V o R o COS 125 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report o V o R o COS R a !Mr"W Wn 177 1 Received by Inspector:— Phone: (initial): t-1 Cry c.r:�'17 r Page 1 of 4