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W San Joaquin HealthEnvironmental Department Hazelton1868 East • aCalifornia95205-6232 Telephone. Y' I i•) 4W3433 Web.www.sigov.org/ehd Underground i •Programi i Report Facility Name: HSC 25284 No permit to operate Facility Phone: ❑ R Date: 102 HSC 25284(x)(3) No written agreement between tank owner and tank operator to monitor the tank system ❑ V ❑ R ❑ COS Facility Address: HSC 25292.2 Current financial responsibility documents not submitted ❑ V CERS ID: _.. ..J� �F+ I us k...� " w s .. U i?._`,, tau 3 ... ✓:..:.l CCR 2711 UST operating permit application for facility and tank information not submitted or current . ... -t Inspection Contact: ❑ COS Title: CCR 2632(d)(1) Phone: ❑ V ❑ R t 106 CCR 2632(d)(2) Inspection Type: ❑ V Program: ❑ COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed ■ V Consent For: Consent Given By: 108 CCR 2637(0,2638(e) Ml Ins ectlon Photos rx Sample ib nes 'V'Valheeb,a ,1 ❑ R Service Technician Onsite: Exp. Date: Designated Operator: Exp. Date: ❑ V I,,...2 -/I2 tsar' Kat,,-,- n, i „a.._ '�:.t `.f �,,�"�( 7 Iservice Tecnnfclan ManuTacturers t raining: I r_rtt = rtPus,,,,,i� rnriP of RPmuatinne HSC = HPalth and Safety Cnde CFR =Code of Federal Reoulations V = Violation R = Repeat violation COS = Corrected on site during inspectio I File Review I 101 HSC 25284 No permit to operate ❑ V ❑ R ❑ COS 102 HSC 25284(x)(3) No written agreement between tank owner and tank operator to monitor the tank system ❑ V ❑ R ❑ COS 103 HSC 25292.2 Current financial responsibility documents not submitted ❑ V ❑ R ❑ COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current ■ V ❑ R ❑ COS 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan ❑ V ❑ R ❑ COS 106 CCR 2632(d)(2) Failed to have an approved UST response plan ❑ V ❑ R ❑ COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed ■ V s R ❑ COS 108 CCR 2637(0,2638(e) Failed to notify the EHD 48 hours prior to conducting testing ❑ V ❑ R ❑ COS 109 CCR 2637 Failed to test secondary containment ❑ V ❑ R ❑ COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days ❑ V ❑ R ❑ COS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually ❑ V ❑ R ❑ COS 112 HSC 25284.2 Failed to test spill containers annually ❑ V ❑ R ❑ COS 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days ❑ V ❑ R ❑ COS 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down ❑ V ❑ R ❑ COS 115 CCR 2715(a) Failed to inform the EHD of designated operator identification or change within 30 days ❑ V ❑ R ❑ COS 116 CCR 2715 Designated operator, service tech or installer did not possess current ICC certification ❑ V ❑ R ❑ COS 117 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after ❑ V ❑ R ❑ COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑ V ❑ R ❑ COS 119 HSC 25299 Documents were falsified or misrepresented ❑ V ❑ R ❑ COS 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification ❑ V ❑ R ❑ COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ■ V ❑ R ❑ COS 122 1 CCR 2631 Q) Failure to submit UST system component statement of compatibility for substance stored ❑ V ❑ R ❑ COS Un Wte Kecoras 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions ■ V ■ R ❑ COS 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6112 years ❑ V ❑ R ❑ COS 203 CCR 2712(b) I Failed to maintain records of monitoring, repair, lining, and upgrades on site ❑ V ❑ R ❑ COS