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0 0 <br />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,siaov.oraJehd <br />CONTINUATION FORM <br />Page: 4 of 4 <br />El I. -IN -ME RE PORT <br />Date: 08/06/14 <br />UST <br />-C-1-104 <br />Facility Address: 2501 Jackson Ave, Escalon <br />_Program; <br />SUMMARY OF VIOLATIONS <br />(CLASS 1, CLASS 11, or MINOR -Notice to Cam p!&_-- <br />205. The December 2013 and May 2014 designated operator monthly inspection reports were not found <br />on site. Designated operator monthly inspection reports for the previous twelve months shall be <br />retained on site. Locate and ensure that copies of the previous twelve months of designated operator'� f" <br />monthly inspection reports are maintained on site. Submit copies to the EHD by September 7, 2014. <br />MINOR- Notice to Comply: 105, 106, 109, 999 <br />105. LIST Tank Information forms for tanks TA0507895 and TA0507897 are not current in CERS. Any <br />change of information must be updated in CERS within 30 days of the changes. Immediately log into <br />CERS, update the required information the <br />per submittal comments provided in CERS, and subm <br />by the EHD. Complete <br />review a separate tank form for each tank. <br />106. The monitoring plan for TA0507896 tank is not current and not approved by the EHD. The <br />monitoring and response plans must be current and approved by the EHD. Immediately log into CER*' <br />update the required information per the submittal comments provided in CERS, and submit for review by <br />the EHD. Complete a separate record for each tank. <br />109. Annual monitoring system certification, leak detector testing, and spill container testing was <br />conducted on 8-8-2013 and a test report was submitted to the EHD on 10-4-2013. A copy of the test�A <br />report must be submitted within 30 days of testing. Ensure that future test reports are submitted to the <br />EHD within the requisite time frame. <br />999. According to the California Environmental Reporting System (CERS) upload, dated 41112014, <br />the existing Owner Statement of Designated Operator is being stored at facility. Facility <br />operators are now required to upload the following LIST program documents Into the California <br />'Environmental Reporting System (CERS): LIST Monitoring Site Plan, UST Certification of <br />Financial Responsibility, LIST Response <br />Plan, LIST Owner/Operator: Written Agreement (if <br />applicable), LIST Letter from Chief Financial Officer, and Owner Statement of Designated UST A <br />Operator Compliance. Immediately log into CERS and upload the required Information <br />Complete and submit a copy of the Return to Compliance Certification form with a statement of how <br />each violation was corrected, including supporting documentation, by September 7, 2014. <br />Provided: <br />-Return to Compliance Certification <br />-Schedule of Free Classes <br />ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />EHD Impector. <br />Received By: — <br />T"e: <br />Elena Manzo (209) 953-7699 <br />oc-1 � <br />F <br />EHD 23-02-003 Rev 04/19112 <br />CONTINUATION FORM <br />A0 <br />