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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.si oqy.org/ehd Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Hate: Costco Wholesale#658 (209) 830-5340 September 22, 2016 Facility Address: CERS ID: 3250 W GRANT LINE RD, Tracy, CA 95377 10146285 Inspection Contact: Title: Phone: Dennis Bock Manager O - Inspection Type: Program: ROUTINE INSPECTION - Operating Permit 2361 - UST FACILITY Consent For: I Consent Given By: 0 Inspection 0 Photos ❑ Sam les I Tony Haggard, Supervisor Service Technician Onsite: Exp. Date: Designated Operator: Exp. Date: Issac Andersen 06/15/2018 Kaylynn Rummell 06/15/2018 Service Technician Manufacturer's Training: Veeder Root, 09126116; VMI, 03/20/17 CCR=California Codeo 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 71 V ❑R D COS 102 HSC 25284(a)(3) No written agreement between tank owner and tank operatorto monitor the tank system ❑V n R ❑COS 103 HSC 25292.2 Current financial responsibility documents not submitted D V o R D COS 104 CCR 2711 UST operating permit application forfacility and tank information not submitted or current o V D R D COS 105 CCR 2632(d)(1) Failed to have an approved UST monitoring pian o V D R D COS 106 CCR 2632(d)(2) Failed to have an approved UST response plan D V D R D COS 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed D V D R c COS 108 CCR 2637(f),2638(e) Failed to notify the EHD 48 hours prior to conducting testing D V E R a COS 109 CCR 2637 Failed to test secondary containment n V D R rt 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 D V D R c COS 112 HSC 25284.2 Failed to test spill containers annually D V D R c COS 113 CCR 2638(d) Failed to submit monitoring system certification test report within 30 days D V D R c COS 114 CCR 2636(f) Failed to perform 0.1 gph annual line test for pressurized piping without fail safe or shut down D V D R D COS 115 CCR 2715(a) Failed to inform the EHD of designated operator identification or change within 30 days n V D R D COS 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification D V D R D COS 117 CCR 2663 Failed to inspect a lined or repaired steel tank within 10 years of lining and every 5 years after D V D R D COS 118 CCR 2663 Failed to submit tank lining certification within 30 days or to conduct proper tests D V D R c COS 119 HSC 25299 Documents were falsified or misrepresented D V D R D COS 120 CCR 2635(d) Failed to submit UST Certification of Installation/Modification o V e R e COS 121 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report D V D R c COS 122 CCR 26310) Failure to submit UST system component statement of compatibility for substance stored D V D R c COS On Site Records 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions D V ❑R ❑COS 202 CCR 2712(b) Failed to maintain cathodic protection test records on site for at least 6 112 years o V D R D COS 203 CCR 2712(b) Failed to maintain records of monitoring,repair,lining,and upgrades on site D V D R D COS FA0013810 PRO518288 SCO01 09/22/2016 EHD 23-01 Rev.09122/16 Page 1 of 4 Underground Storage Tank Program OIR