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May 21 19 , 04 ; 42p p , 3 r.t. . . AY t � € 1 j Environmental Health Department f ~. � r4 ,E . 14 4. r F e, - Und31C7C '�l tat # = � 1 FI F r - � . - . . , Facility Name Facility Address: Date: WOODBRIDGE AM PMk 18806 N LOWER SACRAMENTO RD Aril 09 2019 r . _ _- - 1 t $ it 121 GCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ❑ V ❑ R c COS' 122 CCR2631 , 2640. 11 Failure tosubmil and/or maintain documentation regarding compalliblillyfor USTsystem components c V ❑ R ❑ COS 2665, 2711 123 CCR 2637. 1 (d), Failure to submit the "Spill Container Testing Report Form" within 30 days after the test ❑ V u R n COS 2637. 1 (e) 12] CCR 263702(d&e), 'OverFll Prevention Equipment Inpec stion Report Form" not submitted within 30 days of inspection c V ❑ R ❑ COS 2665(a&b) IFI FFL 201 CCR 2712(b) Failure to maintain monitoring , maintenance , and follow up action fiecords rF V _`R ❑ COS 202 CCR 2715(c )(3), Failure to maintain the 'Facllity Employee Training Certificate, on-site (after October 1 , 2018) 27 ■ V ❑ R COS 15(c 4 203 CCR 2712(b) Failure to maintain records of repairs, lining , and upgrades on site, for the fife of the UST ❑ V ❑ R ❑ COS 204 CCR 2712(i) Current monitoring plan approved by the EHD not found on site ❑ V ❑ R E) COS 205 CCR 2712(1)9 2634(e) Failure to submit a current UST Response Pian and have it available onsite ❑ V ❑ R e C05 206 CCR 2712 Failure to comply Wth UST operating permit conditions n V ❑ R In, COS 207 HSC 25294 Failed to record unauthorized release from primary containment ❑ V = R D COS 208 CCR 2650(e), 2652 Failed to notify the EHD of a reportable unauthorized release and/or prepare a report c V n R n COS 209 CCR 2716(a-e) Failure to conduct the designated UST operator visual inspection at least once every 30 days r V ❑ R c COS 210 CCR 2716(f) DO monthly reports not maintained on site for 12 months or for 36 months (after October 1 , 2018) o V e R 13 COS 211 CCR 2715(c)(2) No employee present that were trained in the operation and maintenance of the UST system by a DO ❑ V ❑ R COS 212 CCR 2716(f)(2 ) Unstaffed facility failed to have or implement a training program approved by the EHD VV ❑ R c COS 213 HSC 25281 ,5(b )(2) Unburied fuel piping at marinas not visually inspected at least daily or fog not kept ❑ V o R c COS 214 HSC 26281 .5(b)(3) Unburied emergency generator fuel piping not visually inspected at least monthfy or log kept o v R Gds 215 CCR 271AI) Failure to retain a copy of the permit to operate at the facility a z V In R ❑ COS IF&. _T z i s �. . . r1tt .lil? ttflt, , _ - 44 301 HSC 25292. 1 (a) UST system is not operated to prevent unauthorized release, Including spills and overfills ❑ V ❑ R ❑ COS 302 HSG 25291 (b) UST system incapable of detecting leak from primary into secondary containment fIf ,pre-Jul 2003) ❑ V ❑ R ❑ CO5 303 HSC 25290.2(d ) Monitoring system not maintained to detect entry into secondary containment (Jul 2003-Jun 2004) ❑ V ❑ R ❑ COS 304 HSC 2529D. 1 (d) Monitoring system not maintained to detect entry into secondary containment (after Jul 2004 ) ❑ V o R ❑ COS 305 HSC 25290. 1 (e) VPH monitoring of the interstitial spaces of the UST system is not mainte ned u V ❑ R ❑ C05 306 CCR 2630(d) Monitoring equipment is not installed or maintained to detect a leak at the earliest ooport.anity o V ❑ R n COS 307 CCR 2631 (8), 2632(c) Monitoring system of the interstitial space of a double walled system not maintained c V R ❑ COS 308 CCR 2636(rl Failed to maintain a continuous monitoring system that activates an audible and visual alarm c V C R COS 309 CCR 2636(f)( 1 ) Monitoring in sump ! UDC failed to activate an audible and visual alarm or stop the flow product ❑ V c R COS 310 CCR 2636(f)(4) Piping is not fail-safe outside UDCs or fails to stop flow of product at dispenser inside UDCs ❑ V r R = COS 311 CCR 2638(a), 26410) Failed to property program, calibrate, operate , or maintain leak detection equipment ❑ V ❑ R c COS FAIYDD9607 PRO232388 SCD01 0410912019 EHD 23.01 Rev. 09128/2018 Page 2 of 6 Underground Storage Tank Program OR 1868 E. Hazelton Avenue j Stockton , California 95205 1 T 209 46813420 ( F 209 464-0138 1 vvwtv . sjcehd.com