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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.sigov.org/ehd Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: RALEYS FUEL STATION#i56916) 373-3333 July 20, 2017 Facility Address: CERS ID: 4219 E MORADA LN, STOCKTON, CA 95212 10185183 Inspection Contact: Title: Phone: Dawn Dircksen Manager (209) 956-9300 Inspection Type: Program: ROUTINE INSPECTION -Operating Permit 2351 - UST FACILITY-2481 COMPLIANT Consent For: Consent Given By: 0 Inspection 0 Photos 0 Samples I Dawn Dircksen, Manager Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: Michael Briggs 05/30/2019 Kris Bell 11/30/2017 Service Technician Manufacturer's Training Veeder Root,04/26/19; VMI, 06/01/19 UUK=Ualitornia Uodeo egu a ions HSC=Health and SafetyCode CFR=Codeo a erel Regulations V=Violation R=Repeat violation COS=Corrected on site during inspection File Review 101 HSC 25284 No permit to operate c V ❑R c 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 CCR 2632(d)(1) Failed to have an approved UST monitoring plan ■V ■R ❑COS 106 CCR 2632(d)(2) Failed to have an approved UST response plan ■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 o V ❑R ❑COS 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days ❑V o R ❑COS 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually ❑V in 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 designated operator identification or change 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 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after ❑V ❑R ❑COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑V ❑R ❑COS 119 HSC 25299 Documents were falsified or misrepresented ❑V ❑R ❑COS 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification ❑V ❑R ❑COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report n V ❑R ❑COS 122 CCR 26316) Failure to submit UST system component statement of compatibility for substance stored ❑V ❑R ❑COS On Site Records 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions m V m R ❑COS 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 1/2 years ❑V n R ❑COS 203 CCR 2712(b) Failed to maintain records of monitoring, repair,lining,and upgrades on site ❑V ❑R ❑COS FA0016523 PRO524617 SCO01 07/20/2017 EHD 23-01 Rev.09/22/16 Page 1 of 4 Underground Storage Tank Program OIR