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<br /> 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.sipov.ora/ehd
<br /> Underground Storage Tank Program Inspection Report
<br /> Facility Address: Date:
<br /> Facility Name: ��a'. 2?l�'�
<br /> ()(AK �I I I I S., i iNG'OLN 11( %`I ) i ,
<br /> SUMMARY OF VIOLATIONS
<br /> (CLASS I,CLASS II,or MINOR-Notice to comply)
<br /> Item# Remarks
<br /> CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days.
<br /> `, new dl +.I�) ,wd opi � i : 1 r ' u ta�t1 the /"p�rIV�4, 1C11� r9 ��tnr I)(,[lilt 1w.,jiectirin alyd
<br /> notlfr(:aticrt i,vAtt; nut o0vlded e t- 4.)t:ilhar 30 aklvs of ll{r' r:hartalt n t Ilo d to they E 1111
<br /> InIII lr�( latrdy la){t 1+Itt) tilt. C':Ilitr)Illia) Emv,runlnent+al � ' tnr tdli^, Itarallty 1�his
<br /> httl � . ,aa.t,�a qk)v acrid liplon(I the'= notilocatioll identitylnrl All it
<br /> viel,lii.ril �,<as n(.)tcd oil tile. previoll'; in,peclion report dated Augo%[ ail
<br /> 1"tli i i.-trr,'It, violation. (lass "I
<br /> i." CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report.
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<br /> .:,.;.I�.,rr repolt vr:. f'_-'tied Idi-lt{tdrilt{tl wit)riar,aholl W
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<br /> .nl)Iriii+ , t„ t;)lutct itlr;:,It(y ir7ft-),,r)rrl{�t -+Ut�l� ���a� retluireti i:} t.r: _w11k�irwiiR��t1 t)�< �l�lr:rr�lrt;l �tl ?0 F
<br /> iluw: inf,)Inrtllir)n has irtat t7a=ern i�sct?i��eo {r�, lilt , �l.;Utan N 1I reslalfrt7(l io :a rta�il c+ail�th,hr��nt �.laiu:, icSr this hlctlity
<br /> r "'0 day" to submit ttl avnttt'll Ira,l,Unse thal 1111 tides a
<br /> Ari ollt,irator that re(aclve.y al! msp emir 1, t t •n i,.{l have J r
<br /> :,9z tewtrtit nt dcatuuraaeniin t uurrE.c.tive �actiul, t)rc�lytasira tc�,n c.tivt- ,caiurt�; u,Oich v1ill hP t kF n Unsure thaal ;x
<br /> cu�,ratitierl withua 'i0 r1�1ys, (Itmitten leSpollse docummnting correctivo a(-fioll" talrell of I'alr;prl,e.d I��� It�-(�iving <ar!
<br /> 111spectiun report
<br /> rh- i, - Glasse 11 Violation.
<br /> Designated operator did not inspect all required items and/or the inspection reports not completed.
<br /> CCR 2715 D 11-, nt ttrtrnt :51iny oil ttrt
<br /> ttlC. 4lf Il'{11.'att,,(l Ut)(~r )I .)il itt ,.i4 3i{,, I {i(p; (;tJ11F(t tP+`} Yf it 4? 1(7tl tIl{'
<br /> e,tt�t,t 1 1014 ihlough Augu` L�i l 1 :IjeSwj>t le'd Iti)tela`or�tCi� IAIrly 7urinq)1hFru�;i)tt1 ly illStat�rUo�1�tht� Ito ignalled�)pel'ratof
<br /> testier) �<1�, listed as Apt 2'.� �� y
<br /> (ia111 chec k that all re sluiced tc.raulc�l 4�Itacf rlar,lilat nant;e for the UST'sy�lent Ir:,ve. beell)i �olliploled and cics, elralt,rrt ttt(
<br /> ;;9it35 they were, (:lora€ t_rtst.aia; thtat tlesignaled opr�ratort�. lre)fornllnq monthly inspe(.til,ns at ttll�� tEas_iirty ale: Includrntt
<br /> ,-ill cit thf.required intorlwilion i)n tale wpnf#s
<br /> i tdi`b t:3 n"1 tF_pe at Vi0kitioll. U1: .'
<br /> Overall Inspection Comments:
<br /> Irl ltf' fv ,-'C:,IlCIl1Ct 3 IC7Utlrlr 11x11 ILLtiJ(1U(1C1 Stt?ici,}t> t lt1lC ln' tx. :il:)i Crit, tlw ri)(�r11tnr11 g ����t?'lli C'< rtlfl �tlr E� �r1C ``•jil I
<br /> ront�ainc:r r(a;.t.rr7g wa,, c:oncturted WALK ust '19, 201
<br /> (.)rrat)lc t(�s i atd � �Ibmit a copy of the Return to Compliance Certification form to the EHD 'with a statement
<br /> loc�lrrte�nlir)ct the corrective actions haat have 1:)eerl or will be taken for eat;ft violation. At id any strplal�rt�ir�lg
<br /> papetwork, by September 27. 2015
<br /> hlea;P bre aw< rc (fiat a:> of ,Jrrrtarary '1, 201-1. facility operators are required to upload the f0Il0VAI'19 (.)S'I' program
<br /> c1ocl.tment A uitc.,t the C:;aiitornia Frivironmer7taI Reporting System (C.; FSS): t!>T Motlitt�rinc} ;,ite {'ran
<br /> e vial f esF�nt,a�iltllt of tie.,Response
<br /> tei c.,c1 �p ratot t�c>atipli Ict 1 (17hc11`.f Financial nr r.al 1npt er (if
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<br /> �., r�tfsl afit)I r r)f l lllar7�. U;-1- C)�(,�I,,,It�l;^°gator' Writic�r`r
<br /> if)fllll..sk)la,� i ti)d the Owner Sta 1 � Date:
<br /> Inspector: Phone:
<br /> Received by `x;�itir)r f�.t= .1��� (2Q9) �r� , fEc�scl irlt3l��Il�'C1'1,"+'i
<br /> (initial): 1-ENA MAN 1 C) ,
<br /> Page 5
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