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S A N J O A Q U i N Environmental Health Department COUNTY AMENDED -e(rtness grooms here. 9/12/2019 Underground Storage Tank Program Inspection Report Facility Name: L925) acility Phone- Dale: Lawrence Livermore National Lab-Site 300 422-9777 Au ust 13 2019 Facility Address: CERS ID: 15999 W CORRAL HOLLOW RD. TRACY CA 95376 10154767 Inspection Contact: Title; -T Phone; Eric Mertesdorf Environmental Analyst (9251789-7828 Inspection Type: Program: ROUTINE INSPE O -O eratin Permit 2361 -UST FAC ILI T Y Consent For. Consent Given By! F Inspection L Phctos M Sam les Eric Mertesdorf,Environmental Analyst Service Technician Onsite: Exp,Date: Designated Operator: Exp.Date., Brian D Thornton 0312fi12020 Brian D Thornton 03/20/2020 Service Technician Manufacturer's Training: VR 05/20/21 VMI 01x09121 SB 03/14/20 CCR-Td a 23 Ca domia Cate of Regulations HSC Health and Safely Code CFR=Conn of Federal Regulations V=Violation R=Repeat v olahDn COS=Corrected on site during inspection File Review 101 �HSC25284:CCR Failed to obtain a permit to operate from the EHD including but not limited to unpaid permit fees o V o R :.COS 2711(d) 102 HSC 25284(a)(3)(A)r No written agreement between tank owner and tank operator to monitor the tank system o V r.R COS (8) 103 HSC 25292.2,25299.30 Failure to submit and ma:ntain comp ete and current financial responsib.10 documents a V =R COS 104 CCR 2711 UST operating permit app scat on for facility and tank information not submitted or current D V =R ..COS 105 CCR 2632(d)(1) Failed to have an approved UST monitoring plan o V o R COS 2634(d) 106 CCR 2632(d)(2) Failed to have an approved UST response plan D V o R o COS 2634(e) 107 CCR 2632(4).2641(h). P,ot planlsite map not submitted or failed to onmpletely show where mon torng is performed a V D R o COS 2711(a) 108 CCR 2637,2638(e), Failed to notify the EHO 48 hours prior to e-nnducting testing V o R o COS 2643(g) 109 CCR 2637(a-d),2712 Failed to test secondary containment,or failed to maintain test records for 36 months ;V o R o COS 110 CCR 2637(e),2637(f) Failed to submit"Secondary Containment Testing Report Form`within 30 days after the test iV o R o COS 111 CCR 2638,26410), Failed to test monitoring and leak detection equipment every 12 months V iiR c COS 2715(f) 112 HSC 25293 Failure to rria!ntain UST records to enable the UPA to determine whether the UST is in compliance n V ri R rt COS 113 CCR 2638(c),2638(d) Failure to submit"Monitoring System Certification Form"within 30 days of completion of the test o V u R o COS 114 CCR 2636(0(3), No 0.1 gph annual line integrity test for pressurized piping,or within 30 days after repair o V o R o COS 2643(c)(3) 115 CCR 2715(a)(1)(B), "Designated Underground Storage Tank Operator Identification Form' not submitted within 30 days t V o R O COS 2715(a).,3) 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification o V a R o COS 117 CCR 2663, 2712(b)(6) Failure to comply with tank lining,recordkeeping,and inspection requirements o V c R c COS 118 CCR 271 Na)(1)(A), Failure to submit the"Underground Storage Tank Statement of Understanding and Compliance Form" V r7 R D COS 2715 a 2 119 HSC 25299(a)(8), Documents were falsified or misrepresented o V o R COS ��t5299(bj(7) 2635(d) Failed to submit UST Certification of Installation/Modification =V c R o COS FAODD3934 PRO231945 SC001 08!1312619 EHD 23-01 Rev OMI/2019 Page 1 of 5 Underground Storage Tank Program OtR 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-34201 F 209 464-0138 www.$)cehd.com