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Page 1 of 5 San Joaquin County `'W Environmental Health Department 1868 East Hazelton Avenue, Stockton, California 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd Underground Storage Tank Program Inspection Report Facility Name: 1=tKbF1iNu (3A6 Facility Phone: (209) 477-8004 Date: January 28, 2016 Facility Address: 4445 N PERSHING AVE, STOCKTON, CA 95207 CERS ID: 10181565 Inspection ContactTitle: Stephanie Ahmad Manager Phone: (209) 477-8004 Inspection Type: ROUTINE INSPECTION - Operating Permit Program: 2361 - UST FACILITY Consent For. Z Inspection IN Photos O Samples Conan Given By: StephanieAhmad, Manager Service Technician Onsite: Jason Haase Exp. Date: Designated Operator: 07/01/2016 Jason Haase Exp, pate: 02/06/2017 Service Technician Manufacturer's Training VR, 08/25/17, VMI, 06/10/16 CCK = California Uodeo egu ations HSC = Health and Safety Code CFR = Codeo a era Regulations V = Violation R = Repeat violation COS = Corrected on site during inspection File Review 101 HSC 25284 No permit to operate -. V -R C COS 102 HSC 25284(aH3) No written agreement between tank owner and tank operator to monitor the tank system DV ❑ 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 plan/site map not submitted or failed to completely show where monitoring is performed ❑ V ❑ R ❑ COS 108 CCR 2637(f), 2638(e) Failed to notify the EHD 48 hours prior to conducting testing ❑ V ❑ R ❑ COS 109 CCR 2637 Failed to test secondary containment ❑ V ❑ 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 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 DR ❑ 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 125 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report DV ❑ R ❑ COS Received by (initial): � Inspector: FATINAH ZAREEF, REHS hone: (209) 953-7311 ate: 01/28/2016 Page 1 of 5