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4 � <br /> 'NWe San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone: (209) 468-3420 Fax:(209)468-3433 Web:www.sfgov.orglehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Name: Facility Phone: Date: <br /> COUNTRY MARKETPLACE 209 941-2222 March 08 2016 <br /> Facility Address: CERS ID: <br /> 1789 W CHARTER WAY STOCKTON CA 95206 10182247 <br /> Inspection Contact: Title: Phone: <br /> Sim Grewal Manager 209 941-2222 <br /> Inspection Type: Program: <br /> ROUTINE INSPECTION - Operating Permit 2361 - UST FACILITY <br /> Consent For: I Consent Given By: <br /> El Inspection Z Photos 0 Sam les I Sim Grewal Manager <br /> Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: <br /> David Rouse 09/30/2016 Karen Arnaiz 05/05/2017 <br /> Service Technician Manufacturer's Training: <br /> Veeder-Root 10121116; VMI 10/08/16 <br /> CCR=California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations <br /> V=Violation R=Repeat violation COS=Corrected on site during inspection <br /> File Review <br /> 101 HSC 25284 No permit to operate o V ❑R -i COS <br /> 102 HSC 25284(a)(3) No written agreement between tank owner and tank operator to monitor the tank system ❑V ❑R ❑COS <br /> 103 NSC 25292.2 Current financial responsibility documents not submitted ■V a R ❑COS <br /> 104 CCR 2711 UST Operating Permit Application for Facility and Tank information not submitted or current in V ❑R ❑COS <br /> 105 HSC 25286(c) Current BOE number not submitted ❑V in R ❑COS <br /> 106 CCR 2632 Monitoring and response plans not current or approved by the EHD in V ❑R ❑COS <br /> 107 CCR 2632(d)(1)(C) Plot plantsite map not submitted or failed to completely show where monitoring is performed ❑V ❑R it COS <br /> 108 CCR 2637(f),2638(e) Failed to notify the EHD 48 hours prior to conducting testing ❑V ❑R ❑COS <br /> 109 CCR 2637 Failed to test secondary containment a V ❑R ❑COS <br /> 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days ■V ■R ■COS <br /> 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually ❑V ❑R ❑COS <br /> 112 HSC 25284.2 Failed to test spill containers annually ❑V ❑R ❑COS <br /> 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days n V ■R ❑COS <br /> 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 <br /> 115 CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days ❑V ❑R ❑COS <br /> 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification ❑V in R ❑COS <br /> 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1000'of a public well ❑V in R ❑COS <br /> 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test ❑V in R 71 COS <br /> 119 CCR 2644.1(a)(5) Failed to submit ELD test results within 60 days ❑V ❑R ❑COS <br /> 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 <br /> 121 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests ❑V ❑R ❑COS <br /> 122 HSC 25299 Documents were falsified or misrepresented ❑V ❑R ❑COS <br /> 123 CCR 2661 Permit to repair UST system not obtained ❑V in R ❑COS <br /> 124 CCR 2635(d) Failed to submit UST Certification of InstallationlModification ❑V ❑R n COS <br /> 125 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report ❑V ❑R ❑COS <br /> 126 HSC 25404(e)(4) Failed to report program data electronically ❑V ❑R ❑Cos <br /> Page 1 of 6 <br />