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San Joaquin County Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sggov.org/ehd Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: CHEVRON #92033* 209 465-3440 October 23 2015 Facility Address: CERS ID: 508 W DR MARTIN LUTHER KING JR BLVD Stockton CA 95206 10181345 Inspection Contact Title: Phone: Ravinder Singh Manager 209 465-3440 Inspection Type: Program: ROUTINE INSPECTION -O eratin Permit 2361 - UST FACILITY Consent For: Consent Given By: ❑x inspection 9 Photos ❑x Samples Ravinder Singh, Mana er Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: Felix Ramirez 03/03/2016 Alex Jabbart 10/06/2014 Service Technician Manufacturer's Training VMI 11/12/15 Veeder Root 07/07/16 Tank Tester05/31/17 CCR= alifomia Cotle of Regulations H = ealth and Sa e =Code of Fetleral Regulations V=Violation R=Repeat violation COS=Corrected on site during inspection File Review 101 HSC 25284 No permit to operate ❑V o R ❑COS 102 HSC 25284(a)(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 HSC 25286(c) Current BOE number not submitted ❑V ❑R ❑COS 106 CCR 2632 Monitoring and response plans not current or approved by the EHD ❑V ❑R ❑COS 107 CCR 2632(d)(1)(C) Plot plardsite map not submitted or failed to completely show where monitoring is performed ■V ❑R ❑COS 108 CCR 2637(%2638(e) Failed to notify the EHD 48 hours prior to conducting testing ❑V ❑R ❑COS 109 CCR 2637 Failed to test secondary containment o V o 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 1 CCR 2715(a) Failed to inform the EHD of a change of designated operator 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 HSC 25292.5 Failed to conduct ELD testing on a system located within 1000'of a public well ❑V ❑R ❑COS 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test ❑V ❑R ❑COS 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days ❑V ❑R ❑COS 120 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after ❑V ❑R ❑COS 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑V ❑R ❑COS 122 HSC 25299 Documents were falsified or misrepresented ❑V ❑R ❑COS 123 CCR 2661 Permit to repair UST system not obtained ■V ❑R ❑COS 124 CCR 2635(d) Failed to submit UST Certification of Installation/Modification ❑V ❑R ❑COS Received Impactor: Phone: Date: (initial): STACY RIVERA, Senior REHS � (209)468-3440 10/23/2015 Page 1 of 5