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SAN J O AN I N Environmental Health Department COIj CITY Underground Storage Tank Program Inspection Report Facility Name: Facility Phone: Date: CITY FOOD & LIQUOR (209) 647-4273 January 03, 2019 Facility Address: CERS ID: 16470 CAMBRIDGE ST, LATHROP, CA95330 0 Inspection Contact: Title: Phone: Amarjit Khinda Owner (209) 321-4134 Inspection Type: Program: ROUTINE INSPECTION - Operating Permit 12351 - UST FACILITY-2481 COMPLIANT Consent For: I Consent Given By: ❑x Inspection ❑x Photos ❑x Sample Amarjit Khinda, Owner Service Technician Onsite: Exp.Date: Designated Operator: Exp.Date: Joe Bartholdi 11/08/2020 Alex Jabbari 10/01/2020 Service Technician Manufacturer's Training VMI, 12/13/19; Veeder Root,02/03/19 CCR=Title 23 California Code of Regulations HSC=Health and Safety Code CFR=Code of Federal Regulations V=Violation R=Repeat violation COS=Corrected on site during inspectio File Review 101 HSC 25284 Failed to obtain a permit to operate from the EHD including but not limited to unpaid permit fees ❑V ❑R ❑COS 102 HSC 25284(a)(3)(A)/(B) No written agreement between tank owner and tank operator to monitor the tank system ❑V ❑R ❑COS 103 HSC 25292.2,25299.30 Failure to submit and maintain complete and current financial responsibility documents ❑V ❑R ❑COS 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current n V ❑R ❑COS 105 CCR 2632(d)(1),2634(d Failed to have an approved UST monitoring plan ❑V ❑R ❑COS 106 CCR 2632(d)(2),2634(e 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 2637,2638(e), Failed to notify the EHD 48 hours prior to conducting testing ❑V ❑R ❑COS 2643(g) 109 CCR 2637(a-d),2712 Failed to test secondary containment,or failed to maintain test records for 36 months ❑V ❑R ❑COS 110 CCR 2637(e),2637(f) Failed to submit"Secondary Containment Testing Report Form"within 30 days after the test ❑V ❑R ❑COS 111 CCR 2638(a)&(b), Failed to test monitoring and leak detection equipment annually ❑V ❑R ❑COS 2641 112 HSC 25293 Failure to maintain UST records to enable the UPAto determine whether the UST is in compliance n V ❑R ❑COS 113 CCR 2638(c),2638(d) Failure to submit"Monitoring System Certification Form"within 30 days of completion of the test ❑V ❑R ❑COS 114 CCR 2636(f)(3),2643(c) No 0.1 gph annual line integrity test for pressurized piping,or within 30 days after repair ❑V ❑R ❑COS 3 115 CCR 2715(a)(1)(B), "Designated Underground Storage Tank Operator Identification Form"not submitted within 30 days n V ❑R ❑COS ,2715(a)(3) 116 CCR 2715 Designated operator,service tech or installer did not possess current ICC certification ❑V ❑R ❑COS 117 CCR 2663, 2712(b)(6) Failure to comply with tank lining, recordkeeping,and inspection requirements ❑V ❑R ❑COS 118 CCR 2715(a)(1)(A), Failure to submit the"Underground Storage Tank Statement of Understanding and Compliance Form" ❑V ❑R ❑COS 2715(a)(2) 119 HSC 25299(a)(8), Documents were falsified or misrepresented ❑V ❑R ❑COS 25299(b)(7) 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 ❑V ❑R ❑COS 122 CCR 2631,2640.1, Failure to submit and/or maintain documentation regarding compatibility for UST system components ❑V ❑R ❑COS 2665,2711 FA0000185 PR0231532 SCO01 01/03/2019 EHD 23-01 Rev.09/28/2018 Page 1 of 4 Underground Storage Tank Program OIR 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com