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HAZARDOUS WASTE y' BAKERSFIELD FIRE DEPARTMENT
UNIFIED PROGRAM CONSOLIDATED FORMS Prevention Services
H E R s V w D 2101 H Street
SMALL QUANTITY HAZARDOUS FIRE 3;5 Bakersfield, CA 93301
WASTE GENERATOR INSPECTION ARrN T phone: 661 -326 -3979. Fax: 661 -852 -2171
Facility Name:".' Date:
Site Address: °`; 2 0 Q J9 t710-11'- Oq U(.. Time In: Time Out:
Owner/Operator: Phone: EPA ID #�-
Type of Inspection
. Routine 0 Re- inspection/Follow -up 0 Combined Routine Inspectio 0 Joint Inspection 0 Complaint 0 Focused 0 Other
CONSENT TO INSPECT GRANTED BY (Name / Title): s
Inspection may involve obtaining photographs, review and copying of records;. and etermination of compliance with hazardous waste handling requirements.
v — ni r n _ IS:
C
V
HAZARDOUS WASTE REQUIREMENT
N/A
CERS
Violation #
COMMENTS
Recordkee in documentation
Generator has an EPA ID number HSC 25143.131
3010002
Hazardous waste, determination made for all wastes
0 Analysis ',K6enerator Knowled a [CCR 66262.401
3030005
/¢
!
Contingency lan information pos ted near phone [CCR 66262.34(d)(2)]
3010022
/
Facility personnel demonstrate training/awareness [CCR 66262.34(d)(2)]
3020001
- I
Manifests/Consolidated Manifest receipts complete [CCR 66262.23(a)]
3010008
Blue co (s) of manifest mailed to DTSC. [CCR 66262.23(a)(4)]
3010011
Bills of Lading/receipts available [CCR 66262.40(a)]
3010010
k
LDRs available and complete CCR 66268.7 (a)
3030006
Onsite'r6cycling reported using UPCF .[HSC25143.101
1
3030001
Container /tank management
Containers are in good condition CCR 66262.34(d)(2)]
3030013
Containers are closed except when adding—removing [CCR66262.34(d )(2)
3030017
Satellite containers at or near point of generation [CCR 66262.34(e) 1 A ]
Empty containers are empty CCR 66262.34(f)]
3030007
Containers inspected weekly [CCR 66262.34(d)(2)
3030019
C rot.. c.
Tanks inspected daily CCR 66262.34 d 2 , 40CFR 265.201
3030027
One container per waste stream at satellite area CCR 66262.34(d)( 2
3030022
q '
Exclude recyclable materials stored in accordance with local
ordinance/hazardous materials codes [HSC 25143.101
3010016
Acc ation Time Limits
Waste is accumulated not more than 90 0/270 CCR 66262.34(d)]---
3030010
Em t containers managed within one year CCR 66262.34(d)]
3030010
Universal waste accumulated less than one year CCR 66273.15(a)
3030011
Used oil filters offsite within 180 (1 year <1 ton) [CCR 66266.130(c)(4)]
3030004
Pb -acid batteries offsite within 180 (1 yr. < 1 ton) [CCR66266.81(a)(3)]
3030002
Labeling/MarUng
Containers are properly labeled [66262.34(f)]
3030007
Excluded recyclable materials marked properly [HSC 25143.9(x)]
3050005
Universal waste container prop erl y labeled (CCR 66273.34 )
3030008
Used oil filters marked "drained used oil filters" [CCR 66266.1301
3030004
Date written on spent lead -acid batteries [CCR 66266.81(a)(6 )(B)]
3030003
"Used Oil" marked on all used oil tanks /containers CCR 66279.21 b
3030007
Tank marked with "haz waste" , contents, start date 66262.34 f)
3030007
Treatment Transport and Disposal/Other
Have-permit/authorization to do treatment HSC 25136.21
3040003
Waste sent with authorized transport en. eligible) [CCR 66263.411
3050001
Waste dimmed of tc authorized oint/ art HSC 25189.5(a)]
3.050002
to ro erl handle a fiance wastes HSC 25212 a
Ej
Efailed
rotection 66262.34(d 2)]
3030032
Print and sign in this box for receipt of this report. Signature does not imply agreement with findings only receipt of report.
INSPECTOR
POST INSPECTION INSTRUCTIONS:
a
+ Correct the violation(s) noted above by Signature (that all violations have been corrected as noted)
+ Within S days of correcting all of the violations, sign and return a copy of this page to:
Bakersfield Fire Dept., Prevention Services, 2101 H St. Bakersfield, CA 93301 Date
�':Y;� r tatty it ,;�{t•i; _
White - RnainPCS Cnnv Yellow— Station Conv Pink- Prevention Services Copy
FD2171 (Rev 9/14)
BAKERSFIELD FIRE DEPT.
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST .:. A... ._....R.......... �..p 2ro1 x Street
FIRE
...:nn. n:. n: u... »L: Fi. xn nx:.. ..:n�S:: ;4:n.n..::i {:.,rc.. n.r.... n .............f.... r':%:"•:
ARTM T Bakersfield, CA 93301
Haz-Mat Business Plan and Inventory Program - k Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME
INSPECTION DATE
INSPECTION TIME
ADDRESS'
PHONE NO.
NO OF EMPLOYEES
_
L ROUTINE ❑ COMBINED ❑ JOINT AGENCY
❑ MULTI- AGENCY El COMPLAINT El RE-INSPECTION
FACILITY CONTACT J
BUSINESS NUMBER
�ID
Consent to Insl2ect Name /Title
i
❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR :2731(c))
El EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
HOUSEKEEPING (CFC- 304.1)
❑ FIRE PROTECTION (CFC:903 & 906)
❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
NY HAZARDOUS WASTE ON SITE? '❑ YES `S-NO
Explain: Si nature of Receipt:
ri
POST INSPECTION INSTRUCTIONS. FOR RETURN-TO-COMPLIANCE:,
Correct the violation(s) noted above by
Within 5 days of correcting all of the violations, sign and return 'a copy of this page to:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
White = Business Copy Yellow — Business Copy to be Sent in after return to Compliance
Signature (that all violations have been corrected as noted)
Date
Pink Prevention Services Copy FD2155 (Rev 1/14)
t s s s
L ROUTINE ❑ COMBINED ❑ JOINT AGENCY
❑ MULTI- AGENCY El COMPLAINT El RE-INSPECTION
C
V
C =Compliance
C ) OPERATION
COMMENTS
V =Violation
.,
Ld°
F-1
VISIBLE ADDRESS (CFC: 505.1, BMC:15.52.020).
�FXr
❑
APPROPRIATE PERMIT ON HAND
(BMC: 15.65.080)
C
❑
CERS UPDATED FOR THE CURRENT CALENDAR YEAR
(H &S 25404(e)
.
�r.
❑
BUSINESS PLAN CONTACT INFORMATION ACCURATE
(CCR: 2729.1)
{
❑
VERIFICATION OF INVENTORY MATERIALS
(CCR: 2729.3)
❑
VERIFICATION OF QUANTITIES
(CCR: 2729.4)
t
❑
VERIFICATION OF LOCATION
(CCR: 2729.2)
❑
PROPER SEGREGATION OF MATERIAL.
(CFC: 5004.1)
�.
❑
SAFETY DATA SHEET AVAILABILITY
(CCR: 2729.2(3)(b))
❑
VERIFICATION OF HAZ MAT TRAINING
(CCR: 2732)
❑ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (CCR :2731(c))
El EMERGENCY PROCEDURES ADEQUATE (CCR: 2731)
❑ CONTAINERS PROPERLY LABELED (CCR: 66262.34 (f); CFC: 5003.5)
HOUSEKEEPING (CFC- 304.1)
❑ FIRE PROTECTION (CFC:903 & 906)
❑ SITE DIAGRAM ADEQUATE & ON HAND (CCR: 2729.2 (3))
NY HAZARDOUS WASTE ON SITE? '❑ YES `S-NO
Explain: Si nature of Receipt:
ri
POST INSPECTION INSTRUCTIONS. FOR RETURN-TO-COMPLIANCE:,
Correct the violation(s) noted above by
Within 5 days of correcting all of the violations, sign and return 'a copy of this page to:
Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301
White = Business Copy Yellow — Business Copy to be Sent in after return to Compliance
Signature (that all violations have been corrected as noted)
Date
Pink Prevention Services Copy FD2155 (Rev 1/14)
BAKERSFIELD FIRE .DEPARTMENT .
FIRE `PREVENTION LNSPECTION P
revent on .Services
B
E: R S F• 'I D.
FIRE' 2101: H Street
Bakersfield, CA 93301
.
AFTM T
Phone: 6.61-326-.3979 • Fax: 66.1-7852-21-71.
DISTRICT BLOCK NO.' DATE Y EE
es
FACILITY ADDRESS, —, r� ry / q j CITY, STATE, ,ZIP J
L/v t
FACILITY NAME' MANAGER'S NAME PH NO.'.
BUSINESS OWNER'S NAME AND.ADDRESS' CITY, STATE, ZIP PH NO.,
BILL TO: .(IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, PH NO..
OCC TYPE OCC LOAD NO. OF FLOORS HIGH :RISE BLDG- RISER DATE'
` *}
El YES L NO S
CORRECT ALL VIOLATIONS VIOLATSON REQUIREMENTS
CHECKED .BELOW No:
1 ' Remove.: an.d:.safely.;dispose, of all "hazardous ",;refuse and d'ry° vegetation on the above premises (CFC
COMBUSTIBLE WASTE/. DRY 3 O t}.. 1 ..1 )
VEGETATION' '
2 Provide non- combustible containers with tight fitting lids for the' storage of combustible waste and
rubbish endin its safe di,s os'al.. CFC 304.3:2: Note; applies to` containers over 40. all.ons.
R 9 � p (.. ) pR. 9
CoMSUSrisLE..STORAGE 3 Relocate combustible stor'age.' °to provide at Iea•st'3 feet clearance around motor fuse box'/fire door (CFC
605.3)
Relocate fire' extinguisher(s) so that the will. "be in a- cons icuous`loca.tion ` hanging on brackets- with the
top to the extin.gu'isher` not more than 5 feet above the floor. (CFC 906 ".5, & 906.9) _. .
EXTINGUISHERS ` 5 Provide and install, amount approved (type &size
__ portable fire
extinguisher to be. immediately accessible for use in. (a.rea) _— ____ _____________ __ ______ (CFC.
TABLE .906.3(1.))
6` Re- charge all fire extinguish.ers., Fire ext{nguishers shall be serviced. at least once each year, ';and /or
after each use, by 'a- person having a .valid license .'or" certificate..' (.CFC 906:2):`
Provide and maintain'. °E'X,IT" sign(s) with-'letters-6 or more inches i.n h' eight over each required exit
SIGNS
(door /win.dow) to fire' esca.pe. ,(CFC, 1011)
:.8 Provide and maintain ap'pro'pri,te.numbers on a! contrastin.d. background and.visi:ble from the .street to
indicate the correct ad.dress'of th-e b,uil.din (CFC. 505.1)
9
.9 Repair.' alt .(cr:acks /.hol,es /o'penings). in plaster irr (location) -_ -- _ _ _ __ __ –_ _ ------- _
FIRE DOORS P.laateri.ng shah, return the surface to. its or "igi'nal fire resistive: condition (CFC"703 1):
FIRE SEPARATIONS.
l p Remove /repair (,item & to c a. ti o n ). -- -- --------- - - - - -= - - - - -- - -- -- - - - - -- - -- 7- -- --
Sel�closin'g doors shah be• designed to close'by. gravity', o.r by the action of_a mechanical.device,.or by an
a`p.proVed smoke' and heat 'sensitive device. Self- closing doors shall have no "a.ttachmen.ts..capab'-1e . of
preventing the;o.p.eration of the closing.de� ice. (CFC 70.3.2)."
it Remove •all obstruc,ti.on from hallways. Maintain all means of egress free of any storage., .(CFC 1028.3)
EXITS
12 Provide:.a contrasting colored and .pe:rmanen.tiy installed electric light over or.near required' exit
(location). __- ____`__ ___ -_.to clearly indicate it as an exit. (CFC 1006,.3)
:STOP 13 Remove all storage and /or other obstructions from fire, escape' landings and stairways stair shafts.:. (Fire,
es, capes' /stair shafts are to be maintained free 'frorn obstructions at_ :all times) (CFC `1003.6)
lq, Extension cords sha,LL not b:e_used:in -lieu. of permanen :t approved..wi,ring:. 'Install add iti-onal��approved
•
ELECTRICAL APPLIANCES, �electrica:i outlets" where .ne.eded. ` (CFC. 605.5.)
15'
Remove, multiple attachment cords -from specific electrical convenience'outlet (on:'e plug,. per outlet) (CFC
605.4).
OUTDOOR BURNING 1& Rec- reational fires ar open burni'n . CFC 307.1
FIREWORKS 1�: io.lations of Section (CF.G5608.1)' &. 8.44.040 (B.M.C.).
OTHER d .
CORRECTION DATE Correct the .'violat.ions -noted !above by:
LEGEND:
( C.F.C. 'CALIFORNIA FIRE CODE'.
CUSTOMER: C.B.C. CALIFORNIA BUILDING CODE
ature) (Please Print Name Legibly, Title)' . B:.M.C. BAKERSFIELD, MUNICIPALCODE
. N.F.P.A. NATIONAL FIRE PROTECTION'
.T ASSOCIATION
hNSPECTOR: l- .
N.E.C. NATIONAL ELECTRIC CODE
Underground Storage Tank Program
DW Inspection Report
Permission to Inspect:
BAKERSFIELD FIRE DEPARTMENT
Prevention Services Division
2101 H Street
Bakersfield, CA 93301
Phone: 661-326-3979
Fax.- 661-852-2171
Business Name: 7-ELEVEN
Date:03/24/2017
Address Name: 9600 BRIMHALL ROAD
Inspector Name: Shane Gardner #8248557
Inspection Type: Routine
Report :Final
[NVO = No Violation Observed OUT = Out of Compliance NA = Not Applicable UD = Undetermined
COS = Corrected On Site RPT = Repeat Violation
Violation
Program Requirement
46 0
0
SOC
Comments
No
:0
:1
0
a.
Ch Z cc
z
0
z
M '
0
4) >
File Review
Facility Tank Information
2030021
Facility has a valid Permit
Tank 1-
to Operate from the
Tank 2
CUPA - 23 CCR 16 2712(1);
Z
❑
F-1
❑
❑
❑
None
Tank 3-
HSC 6.7 25284
Tank 4-
2010010
UST Operating Permit
Application for Facility
information and Tank
information
0
❑
❑
❑
E-1
❑
None
submitted/maintained - 23
CCR 16 2711; HSC 6.7
25286(a)
2010001
Current BOE number
submitted to the CUPA
Z
❑
❑
❑
None
and/or CERS - HSC 6.7
25286(c)
2030011
UST compliance
statement and/or
Designated Operator
Z
❑
None
current certification
submitted - 23 CCR 16
2715(a), 2715(b)
2030046
A complete and accurate
response plan has been
submitted, approved and
Z
❑
❑
❑
❑
None
maintained - 23 CCR 16
2632, 2634(e), 2641(h),
2712(i)
2030041
A complete and accurate
plot plan has been
submitted, approved and
Z
❑
F-1
❑
❑
❑
Minor
maintained - 23 CCR 16
2632(4 )(1)(C), 2711(a)(8 )_
2010006
Owner/Operator has not
made false statements or
representation on any
Z
❑
❑
❑
❑
❑
None
required document - HSC
6.725299
2010003
Owner/Operator has a
DO and/or informed the
CUPA of any change (s)
Z
F-1
❑
❑
None
within 30 days - 23 CCR
16 2715(a)
Violation
Program Requirement
4-
0 0
SOC
Comments
No
10
'.
M
4C
in
0
0-
z
0
z
0
W
Testing
2030002
Owner/Operator has
tested and certified leak
None
detection equipment
annual) v - 23 CCR 16 2638
2030048
Secondary containment
testing conducted every
36 months in accordance
None
with requirements - 23
CCR 16 2637
2030055
Spill buckets have been
tested annually as
N
❑
❑
❑
❑
❑
None
required : HSC 6.7 25284.2
2010009
Secondary containment
test results submitted to
the CUPA within 30 days
None
after the test - 23 CCR 16
2637(e)
2030064
CUPA was poperly
notified within the
prescribed number of
None
hours prior to testing - 23
CCR 16 26370, 2638(e),
2643(g), 2644.1(a)(4)
Install/Repair
2060009
Permits obtained to
install, replace, repair, or
❑
❑
❑
None
modify part of the UST
system - 23 CCR 16 2712
UST System Observation
General Monitoring
2030003
Leak detection system
maintains continuous
RD
monitoring that activates
None
[:1
an audible and visual
Yes
alarm - 23 CCR 16 2632,
2634, 2636, 2666
2030016
The annular space of the
tank, piping and sumps
RD
are continuously
monitored and activates
❑
❑
❑
❑
None
❑
the alarm - 23 CCR 16
Yes
2631(g), 2632(c)(2)(A)&(8),
2633(c), 2636(o
2030017
Product piping outside the
UDC is fail-safe and shuts
down the pump or
None
restricts flow - 23 CCR 16
2636(0(5)
2030018
Turbine sump monitor
RD
activates an audible and
visual alarm or stops the
❑
❑
❑
None
[:1
flow of at the dispenser -
Yes
23 CCR 16 26360(1)
Underground-Storage Tank Program - DW Inspection Report v 2.0
Violation
Program Requirement
d o
SOC
Comments
No
Oj
4
c
O
a
0
z
O
z
D
V
W
of
2030019
Monitoring system in the
UDCs activates an
audible and visual alarm
®
❑
❑
❑
None
or stops the flow at the
UDC -23 CCR 16
2636 (0(1)
2030043
Leak detection equipment
RD
properly programmed or
properly operated - 23
®
❑
❑
❑
❑
❑
None
❑
CCR 16 2632, 2634, 2636,
Yes
2666
2060005
System constructed with
a monitoring system
capable of detecting entry
®
❑
❑
❑
❑
❑
None
into secondary
containment - HSC 6.7
25291 b)
2060014
Correct leak detection
equipment installed for
RD
the type of system
®
❑
❑
❑
❑
❑
None
❑
present - 23 CCR 16 2638,
Yes
HSC 6.7 25290.1, 25290.2,
25291
2060015
Sensor located in the
RD
proper position /location -
®
❑
❑
❑
❑
❑
None
❑
23 CCR 16 2630(d), 2641(a)
Yes
2030062
Facility is in compliance
RD
with not tampering with or
disabling leak detection
®
❑
❑
❑
❑
❑
None
❑
devices or alarms - HSC
Yes
6.7 25299(a)(9)
2060022
System constructed with
a monitoring system
capable of detecting entry
®
❑
❑
❑
❑
❑
None
into secondary
containment - HSC 6.7
25290.2( d
2030034
Tag /sticker on affixed
monitoring equipment
being certified, repaired,
®
❑
❑
❑
❑
❑
None
or replaced - 23 CCR 16
2638(
VPH Monitoring VPH
2030065
Interstitial monitoring of
RD
the annular spaces of the
UST is properly
❑
❑
®
❑
❑
❑
None
❑
maintained - HSC 6.7
Yes
25290.1(e
2060023
System constructed with
a monitoring system
capable of detecting entry
into secondary
❑
❑
®
❑
❑
❑
None
containment - HSC 6.7
25290.1(d)
Underground Storage Tank Program - DW Inspection Report v 2.0
Violation
Program Requirement
0
0.0
SOC
Comments
No
M
-C�
C1
0
Q) o
Z
0
Z
D
W.-
>
Line Leak Detector
2060012
Line leak detector
installed on pressurized
RD
piping system - HSC 6.7
❑
❑
❑
❑
❑
None
❑
25290.1(h), 25290.2(8),
Yes
252910, 25292(e),
2636(o
2030026
Line leak detectors detect
a 3 gph leak and/or
RD
audible and visual alarm
❑
❑
❑
❑
None
❑
function properly - 23
Yes
CCR 16 2636(0(6),
2666(d)
2030027
Turbine shuts down when
a leak is detected or
RD
when line leak detector is
2
❑
❑
❑
None
❑
disconnected - 23 CCR 16
Yes
2666(c)
2030025
Pressurized piping able to
detect a 3.0 gph leak
RD
within an hour, and
2
❑
None
❑
restricts the flow or
Yes
alarms - 23 CCR 16
2636M(2)
Secondary Containment
2060010
UST storing a hazardous
RD
substance has secondary
[D
❑
None
❑
containment - HSC 6.7
Yes
25292
Underground Storage Tank Program - DW Inspection Report v 2.0
Violation
Program Requirement
4-
0
SOC
Comments
No
M
a
CO)
0
0-
0)o
Z
0
Z
D
0
W
.-
a) >
2030008
UDC, sumps, and/or
other secondary
containment in good
❑
❑
❑
❑
None
condition and/or are free
of debris/liquid - HSC 6.7
25290.1, 25290.2, 25291
2030040
Secondarily contained
RD
piping maintained to allow
E�
E:]
E]
❑
None
1:1
liquid to drain into sump -
Yes
23 CCR 16 2630(d), 2641 (a)
2060006
Secondary containment
piping slopes back to the
None
collection sump - 23 CCR
16 263(c)
2030047
Secondary containment
maintained tight and has
been confirmed by testing
❑
None
- 23 CCR 16 2662, HSC 6.7
25290.1(c)(2), 25290.2(c)(2),
25291(a), 25292(e)
2030060
Entry fittings in secondary
containment for UST
system maintained
None
tight/sealed - 23 CCR 16
2630, 2635(d), 2636(c),
2666
2060020
Spill bucket is installed
RP
and has a functional drain
valve or other means to
0
❑
❑
❑
1:1
❑
None
❑
remove liquid - 23 CCR 16
Yes
2635(b), 2665
2030054
Spill bucket maintained in
RP
good condition and free of
Z
None
❑
debris and/or liquid - 23
Yes
CCR 16 2635(b), 2715(c)(2)
2060019
Spill bucket to has a
minimum capacity of five
Z
None
gallons - 23 CCR 16
2635 2665
Overfill
2030035
UST system is operated
RP
to prevent unauthorized
release, including spills
None
❑
and overfills - HSC 6.7
Yes
25292.1 (a)
2030036
Overfill prevention system
RP
has not been overridden
and meets overfill
None
❑
requirements - 23 CCR 16
Yes
2635(b (2), 2665
Underground Storage Tank Program - DW Inspection Report v 2.0
Violation
Program Requirement
4-
00 .0
SOC
Comments
No
4
a
C*
0
0.
0
z
0
z
M
0
w
On Site
Records
Certifications
2030023
Required designated
operators or contractors
maintain a proper and
None
current ICC certification -
23 CCR 16 2715
2030024
Service technician,
installer, and/ or
employee maintain a
None
proper license - 23 CCR
162715
2030031
Employee or contractor
obtained and maintained
proper manufacturer
❑
❑
❑
❑
❑
None
certification - 23 CCR 16
2715
2010007
Submit/maintain current
Certificate of Financial
Responsibility /mechanism
of financial assurance -
None
23 CCR 16 2711; 23 CCR
18 2808.1, 2809-2809.2;
HSC 6.7 25292.2; HSC
6.75 25299.30-25299.34
Designated Operator
2010004
Copies of DO inspections
for last 12 months and list
of trained employees
None
maintained - 23 CCR 16
2715
2030013
Designated operator
properly conducted the
monthly inspection and
None
the reports are complete -
23 CCR 16 2715
2030010
DO notified operator of
any condition observed
during the monthly
None
inspection that may
require action - 23 CCR 16
2715(d)
2030012
DO employee training
performed, current for at
least one employee on
E
❑
❑
❑
❑
❑
None
site, and a log kept - 23
CCR 16 2715(c)(6), 2715(o
Underground Storage Tank Program - DW Inspection Report v 2.0
Violation
Program Requirement
4-
0 4) 0
SOC
Comments
No
0
>
Q
a
0
21
Z
0
Z
Q
W
a>
Logs
2030001
Leak detection alarm
logs, maintenance and
RD
records of appropriate
❑
❑
❑
❑
None
❑
follow-up actions
Yes
maintained - 23 CCR 16
2632, 2634, 2712(b)
Maintenance/Tests
2010008
Monitoring, maintenance,
repairs, linings, and
RD
upgrade records
❑
❑
1:1
❑
❑
None
r_1
maintained for the proper
Yes
time period - 23 CCR 16
2712(b)
Documentation
2030033
Failure to maintain on site
an approved monitoring
2
❑
❑
❑
❑
❑
None
plan - 23 CCR 16 2632,
2634, 2711, 2712(1)
2030037
Written agreement
between the tank owner
and tank operator to
monitor the tank system
❑
1:1
None
is maintained - 23 CCR 16
2620(b); HSC 6.7
25284(a)
2030061
Suspected or actual
RD
unauthorized release
reported in appropriate
❑
❑
E
❑
None
❑
time frame - HSC 6.7
Yes
29294, 29295
General Operating Requirements
Permit Condition/Approval
2030039
Compliance with all
operating permit
Z
❑
❑
❑
❑
F-1
None
conditions - 23 CCR 16
2712; HSC 6.7 25299
2030059
UST system maintained
in accordance with
exclusion/exemption
❑
❑
None
status - HSC 6.7 25281.6,
25283.
2030014
Owner/Operator received
approval and has
implemented a training
❑
❑
E
None
program at an unstaffed
facility - 23 CCR 16
2715 (2
2030015
Facility exhibited that the
method used to monitor
the tank meets the
monitoring methods in
❑
❑
❑
None
2643(f) - 23 CCR 16 2643
Underground Storage Tank Program - DW Inspection Report V 2.0
Violation
Program Requirement
4-
0 .2
4)
SOC
Comments
No
0
>
13
0
(L
42 (a
0)75
z
0
z
M
Q
W
of
Red Tag
2030045
Red Tag information is
legible and has not been
None
tampered with - 23 CCR
16 2717.1(
2030044
Facility did not allow for
deposit of petroleum into
a UST that has a red tag
❑
❑
E
❑
1:1
❑
None
affixed to the fill - 23 CCR
162717.1(0
Install/Repair
2060024
UST system is made of or
lined with materials that
are compatible with the
❑
❑
r-�
r-�
❑
None
substance stored - 23
CCR 16 2631.1
2060021
Striker plate installed and
positioned correctly - 23
None
CCR 16 2631(c), 2662(d)
Z There were no violations noted for this inspection.
❑This report shall serve as a "NOTICE TO COMPLY" for Minor Violations, and a "NOTICE OF VIOLATION" for
Major violations. You are, hereby, ordered to correct the above noted violations within 30 days, or according to
correction summaries provided. Formal enforcement and/or penalty assessment may be initiated for any
violations noted, and for those not corrected in a timely manner. (NOTE: If this is a preliminary report, a final report
will follow.)
732
7
Inspectors Signature. Date: 1
Inspector: Enter # of Violations: RD: <Z—<t:N
Check one box for facility Significant Operational Status (SOC) to be reported to SWRCB and US EPA:
❑ SOC with both Release Detection and Release Detection (Facility has no Release Prevention and no Release
Prevention Violations)
❑ Not in SOC (Facility has both Release Prevention and Release Detection Violations)
❑SOC with Release Detection only (Facility has no Release Detection violations but one or more Release Prevention
violations)
❑ SOC with Release Prevention only (Facility has no Release Prevention violations but one or more Release Detection
violations)
Underground Storage Tank Program - DW Inspection Report v 2.0