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cn <br /> San Joaquin County 16 D <br /> 9171 9690 0935 0084 8378 34 Environmental Health Department f5 <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sigov.org/ehd <br /> Underground Storage Tank Program Inspection Report <br /> Facility Phone: Date: <br /> Facility Name: (209)461-5555 January 20, 2015 <br /> Safeway Fuel Center#1769 <br /> EPA ID CERS ID: <br /> Facility Address: 10156809 <br /> 2808 COUNTRY CLUB BLVD, Stockton, CA 95204 <br /> Facility Contact: Contact Phone: Contact during inspection,if <br /> MANNY NETTO (209)461-5555 different from facility contact: Sandra ma. y/ <br /> Inspection type: Program: <br /> ROUTINE INSPECTION -Operating Permit 2361 - UST FACILITY <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 7HSC <br /> 5284 Eagreement <br /> operate ❑V ❑R ❑COS <br /> 702 5284(a)(3) reement between tank owner and tank operator to monitor the tank system ❑V ❑R ❑COS <br /> 103 5292.2 cial responsibility documents not submitted ❑V ❑R ❑COS104 711 g Permit Application for Facility and Tank information not submitted or current ❑V ❑R ❑COS <br /> 105 5286(c) number not submitted ❑V ❑R ❑COS <br /> 106 CCR 2632 Montorngand response plans not current or approved by the EHD ❑V ❑R ❑COS <br /> 107 CCR 2632(d)(1)(C) Plot plan/site map not submitted or failed to completely show where monitoring is performed in V ❑R ❑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 ❑V ❑R ❑COS <br /> 110 CCR 2637(e) Failed to submit secondary containment test report within 30 days ❑V ❑R in COS <br /> 111 CCR 2638(a) Failed to test monitoring and leak detection equipment annually ❑V in 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 ❑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 in COS <br /> 115 j CCR 2715(a) Failed to inform the EHD of a change of designated operator within 30 days to V to R ❑COS <br /> 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification ❑V ❑R ❑COS <br /> 117 HSC 25292.5 Failed to conduct ELD testing on a system located within 1000'of a public well ❑V ❑R ❑COS <br /> 118 HSC 25292.5 Failed to repair and retest system due to failed ELD test ❑V ❑R ❑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 Installation/Modification ❑V ❑R ❑COS <br /> 125 CCR 2712(f) Failed to submit a written response within 30 days of receiving an inspection report .V in R in COS <br /> 126 HSC 25404(e)(4) Failed to report program data electronically V o R in COS <br /> On Site Records <br /> 201 CCR 2712(b) Failed to maintain alarm logs and/or records of follow up actions r V s.R -COS <br /> Received by(initial): Inspector: Phone: Date: <br /> STACY RIVERA, Senior REHS (209) 468-3440 01/20/2015 <br /> Page 1 of 5 <br />