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W San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California95205-6232 <br /> Telephone. (209) 468-3420 Fax: (209)468-3433 Web.www.sjgov.o[g/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Phone: Date: <br /> QU1K ,-',1'-'MP IMIARKEI', 138 (209,) 835�1-8284 �-iq 2 7, 2015 <br /> Facility Address: CERS ID: <br /> —115`3, U-NCOLAN 'BILVD, 9�53,�76 10�81059 <br /> Inspection Contact: Title: Phone: <br /> Sarni Ad kot,,, Ge.neral "Olanaqer k2 09 )"r 8284 <br /> Inspection Type: Program: <br /> C, 361� - 1,;'ST F/'kCIL! <br /> -ROAL,t iNE J"Peratinq Pd r2' <br /> Consent For: Consent Given By: <br /> K Ins pection [xfl Photos Samples I Sami Nkouss� eneral Manager <br /> Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: <br /> �,,-4A 3/16!201,7 <br /> Service Technician Manufacturer's Training <br /> N <br /> CCR=California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations <br /> V=Violation R=Repeat violation COS=Corrected on site during inspection <br /> File Review <br /> 101 HSC 25284 No permit to operate ❑V Li R o COS <br /> 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system o V o R o COS <br /> 103 HSC 25292.2 Current financial responsibility documents not submitted o V o R o COS <br /> 104 CCR 2711 UST Operating Permit Application for Facility and Tank information not submitted or current o V Ei R o COS <br /> 105 HSC 25286(c) Current BOE number not submitted o V o R o COS <br /> 106 CCR 2632 Monitoring and response plans not current or approved by the EHD 0 V El R o COS <br /> 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed oV oR o COS <br /> [108 CCR 2637(0,2638(e) Failed to notify the EHD 48 hours prior to conducting testing oV oR o COS <br /> 109 CCR 2637 Failed to test secondarycontainment oV EiR o COS <br /> 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days oV oR Ei COS <br /> 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually oV oR Ei COS <br /> 112 HSC 25284.2 Failed to test spill containers annually oV oR o COS <br /> 113 CCR 2638(4) Failed to submit monitoring system certification test report within 30 days EiV oR o COS <br /> 114 CCR 2636(o Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down oV oR 0 COS <br /> 115 CC 2715(a) Failed to inform the EHD of change of designated operator within 30 days mV wR o COS <br /> 116 CCR 2715 Designated operator,service tech or installer did not possess current[CC certification oV oR o COS <br /> 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1000'off a public well o V o R o COS <br /> 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test o V o R o COS <br /> 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days o V o R o COS <br /> 120 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after o V o R o COS <br /> 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests o V o R o COS <br /> 122 HSC 25299 Documents were falsified or misrepresented D V o R u COS <br /> 123 CCR 2661 Permit to repair UST system not obtained ❑V ❑R o COS <br /> 124 CCR 263 <br /> 24 CCR 2635(d) Failed to submit UST Certification of Installation/Modification ❑V ❑R o COS <br /> - <br /> 125 CCR 2712(o Failed to submit a written response within 30 da receiving an inspection report ■V o R o COS <br /> 1 - I- Phone: Date: <br /> Received Inspector: C ' 71' - ,, 2�0 1 <br /> E`-I ' - 1 08/2 <br /> (initial): LENA WM"i"" ""' iio�r t'El-is (209', <br /> I- WE=E��� <br /> Page 5 <br />